Incoming CEO Reicher: Time to embrace the end of proprietary interfaces

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 - Reicher MD

When news broke Feb. 2 that Murray Reicher, MD, had been named chief executive of DR Systems, the San Diego-based supplier of PACS, RIS and EHR systems, more than a few folks surely reacted with an audible “Huh?” After all, Reicher is well known as the founder of the 25-year-old company. Hadn’t he been running it all along?

Not unilaterally. He’s been chairman of DR’s board. The president and CEO of the past 20 years, Richard Porritt, has now retired. “As CEO I’m going to be a little more directly involved in operations in some areas, such as sales and production, where I was more hands-off,” Reicher told imagingBiz when asked how his role would change. “But with regard to my role on the board and the development of the product and the vision and values of the company, that will all stay the same.”

Reicher, who retired from clinical practice in neuroradiology two years ago, took our questions about his company, the healthcare vendor community and the changing face of American healthcare. Excerpts from the conversation follow.

imagingBiz: As you think back over the past quarter century since you launched DR Systems, what changes strike you as most consequential or memorable?

Reicher: What’s striking to me, first of all, is that the technology is constantly changing while the values stay the same. The fundamental values that drive success into healthcare—dedication to outstanding patient care and customer service, whether the customer is the patient, the referring doctor, the facility or all three—haven’t changed. In the case of medical imaging, the fundamental value of trying to push outstanding care by providing the right type of test at the right time for the right individual, and then delivering results promptly and clearly: That value has been constant. Many of the new initiatives that we hear about today, like the ACR’s Imaging 3.0—those of us who have been around for 30 years look at that and say, “Oh, you mean be a good doctor.” Yes, we should know clinical histories better, we should increase our clinical relevance, we should be more active in our communities and our healthcare institutions, we should communicate according to industry standards. Okay. Is that new?

What changes do you anticipate over the next several years?

Social changes and technical changes will continue to influence [care-delivery] strategies. For example, there is an explosion today of consumer-directed healthcare, driven by rising insurance deductibles. There’s a general recognition in our society that health literacy is important. Consumers can use the increasingly transparent delivery of healthcare information as a way of more proactively managing their own health and their outcomes. That’s a good thing, in my opinion. It’s the right thing to do.

For many, many years in radiology, if you had good relationships with your payers and your referring doctors, you were done. Today you really have to stay in contact with your patients. You should be proactive in reminding them about preventive measures that involve imaging and even those that don’t. That has become a big trend over the last five or six years, and it is going to continue.

The other huge trend in our particular space is the move toward unified [healthcare delivery] systems. I would say that, by 2025, we’ll see a significant plurality of integrated delivery networks, with one or two imaging IT vendors providing enterprise systems, dealing with all the imaging ’ologies and all of the workflows associated with medical imaging.

Another big thing is, communications platforms are going to consolidate. I think the enterprise patient portal is going to be big. Enterprise systems for communication—not just with patients but with community physicians and other community-based health resources—that’s a field that’s about to explode.

What hurdles stand in the way of our healthcare system realizing better care through technology?

I guess the best way I can answer that is, we need industry standards in order for various technologies to interoperate. There’s been tremendous progress that has actually accelerated because of the EHR incentive program and the Meaningful Use dataset, along with the prevalence of vendors today that adhere to standards that are interoperable. DirectTrust is a big part of it, I think, as well.

So for there to be an accelerated consolidation of vendors—what helps bring vendors together—is interoperability. It allows for faster integration. And that’s definitely a challenge. But it’s a social challenge. We have a measles epidemic today in the U.S. Population health is different than organized medicine. So there’s a social challenge associated with our communities, our people, our populations recognizing that each individual plays the primary role in determining his or her health. If we did a better job delivering appropriate healthcare, particularly appropriate preventative healthcare, we could reduce up to three quarters of all the chronic disease in the United States. Then we would be able to afford to provide the highest technology healthcare and research for those remaining individuals who have unlucky, unpredictable diseases.

At more of a micro level, there’s a challenge for every healthcare IT vendor that today derives a substantial percentage of their revenue from selling interfaces. They need to embrace the fact that that’s going away. The whole concept of consolidation and interoperability means that the overhead associated with proprietary interfaces has to be wrung out of the system.

This is all part of the concept of value-based healthcare. And that’s a tough one right now because, as you can imagine, the healthcare IT industry is sometimes reluctant to provide and utilize technologies that are bad for business even if they’re good for healthcare.

You’ve been outspoken in calling for radiologists to get up to speed with Meaningful Use. What did you think about CMS’s announcement last week that it intends to modify requirements?

I think it’s great. This program has had tremendous positives and I think it will have tremendous, positive, long-lasting impact on American healthcare. At the same time, it’s a very ambitious program with a lot of flaws. The fact that it’s being rolled out in phases, and that CMS is receding and listening to input from users all across the country, trying to make positive changes as a result of that feedback, is great. I think the main critique I would have of the program right now is that it’s very all-or-nothing. You can put in a system and go to some trouble and expense, and do a lot of great things, but if you miss on one measure—you’ve gotten a 99 attestation, but you have to get 100 or you flunk out—that’s been extremely discouraging to physicians.

The other thing is, all of the various requirements and the complexity of the program have led to a lot of physicians, particularly in fields like radiology, to simply opt out of the program. And CMS has made it very easy for them to opt out by basically granting the specialty a blanket hardship exemption. I personally think that’s a tragedy. Because the main benefit of the program was to stimulate the implementation of healthcare systems that enhance communication between healthcare providers and their patients. For one or two specialties to have low adoption of EHR technology means that there may be specialties that can’t communicate very well with their colleagues and/or their patients. The loser there will be the specialty.