As far as the rock stars of health IT go, the new HIMSS CEO certainly has street cred that belies the stereotype of the tech geek thanks to an early career incarnation at an experimental start-up built on the back of new technology.
That innovative venture went on to transform industries and bring performers including Madonna, Michael Jackson, Van Halen and an Australian outfit called Men at Work into our loungerooms. It was called MTV.
Part of a young guard of trailblazers, during the 80s Harold “Hal” Wolf III worked at the US music video broadcaster as it grew to become a global entertainment behemoth.
But Wolf says those heady days at the cable television network, which he describes with presumed understatement as “a lot of fun”, had parallels with his current work.
“What’s really neat about my career have been the opportunities that have been afforded me to get to the cutting edge and to change the way industries operate,” Wolf tells Healthcare IT News Australia.
Looking back at a TV channel that in its early days would fade to black when an operator changed VHS tapes, it may not seem particularly technologically advanced, but MTV created an early wave disruption.
“It was a young organisation of people who were in their 20s and 30s, very smart, very buttoned up from a business standpoint, and extraordinarily hard working, with a lot of passion around this transformation of entertainment. And it really was very similar in some ways to what we're facing today in healthcare.”
That disruption contributed to the segmentation of the television industry, with control wrested from broadcast giants and the establishment of hundreds of networks, many of them catering to niche audiences. Wolf then went onto work on bringing other technologies into our lives, such as internet access via televisions with Time Warner.
“The parallels between that and healthcare are very similar. We're moving from a state where the healthcare system has been set up to support the hospital, it’s been set up to support the institutions, and now we see them moving more and more to setting up to support the individual,” Wolf says.
Apps designed for specific diseases, electronic medical records on phones, wifi-connected devices that collect health data, genomic fuelled tailored treatments, AI chatbots, predictive population health and digital pharmaceuticals are among the high-tech innovations creating this seismic shift in healthcare.
For Wolf – who after many years in healthcare, including at Kaiser Permanente – was tapped on the shoulder last year to take on the top job at HIMSS, this is a critical revolution.
“Our economics globally are not set up to be able to handle where we're going to be in ten years. We have a large silver tsunami of people who are retiring. You have a shortage of physicians on the horizon, many are retiring soon, especially in primary care, you have a shortage of nurses, people are living longer, and by living longer they're going to contract chronic diseases, they're going to have a higher prevalence just because of age,” he says.
“When you do the math it's very hard for any society to build hospitals fast enough. And if all you're going to do is follow the encounter paradigm; if you built the hospital fast enough you would be challenged to find enough specialist doctors, nursing staff, clinicians to fill it and take care of it.”
Digital “extenders” will be essential to care delivery, not only in remote regions but also in overstretched urban centres. Otherwise, Wolf says, “we do not have a chance from a societal standpoint to deliver on our responsibilities and our opportunities for care”.
Added to this is the expectation that healthcare simply has to adapt to operate in the way the world works.
“There's a fundamental culture change about the use of connectivity, of clinical integration, of ensuring that a patient has a consistent record that can be seen by any physician or appropriate clinician at a time of emergency or just general use. This is something that is becoming I believe very basic in the expectations of individuals globally.
“I can purchase tickets anywhere in the world online and no one says: ‘I really can't show you his travel portfolio because only his travel agency should know’.”
Given the consequence of the digital transformation of healthcare, Wolf has called on the Australian Government to take a greater role in driving progress.
“I think there's no question that you always have had a challenging balance, as every country does, between the funding models,” he says.
“The question will always be from an Australian standpoint: should the Federal Government take a more active approach in funding initiatives, incentivising the transformation?
“Reimbursement models alone are always a great place to start. People respond to reimbursement models and people have a tendency to follow the money.”
The rewards created by an integrated national system would be immense, and Wolf says he derived inspiration on what can be achieved from a meeting he had in South Australia years ago.
Working with McKinsey & Company at the time, he was at a meeting with Country Health SA.
“Their entire process was thinking about the individual home and the individual as an extension of the health system. And it just left this very profound ‘duh’ moment, if you would,” he says.
“I think the ‘a-ha’ moments for me come sometimes less in terms of some grand application or the silver bullet that has the potential for cataclysmic change.”
That epiphany – that health systems are no longer comprised of only hospitals and clinics but include every patient with a smartphone and every house with an internet connection – adjusted the thinking of even this tech evangelist.
“So if we think about trying to achieve at the national level the goals of digital health, of breaking past the encounter-based paradigm, of a vision like Country [Health SA] where each home, each environment, each person has connectivity and can have as many services as possible provided that way, and that becomes incentivised through reimbursement levels, that would be a huge step forward.”
And with each step, according to the man who has seen a few, technology can reach into people’s lives and evolve the way the world works.
“If you can change the course of something by half a degree or one degree, then over time you have the ability to impact millions.”
The HIMSS CXO Dialogue Series 2018 will be held in Melbourne, Sydney and Brisbane from 5-9 February.
HIMSS is the parent company of Healthcare IT News Australia.