Athenahealth CEO Jonathan Bush says the U.S. healthcare system "created Donald Trump" and reveals his company's efforts to turn Epocrates into "a universal remote for EHRs that you hate to use."
With the 2016 presidential election 34 days away and early voting underway, I decided it was time to check in with Bush.
That's Jonathan Bush, co-founder, chief executive officer and president of athenahealth, who also happens to be a cousin of former president George W. Bush. We spoke one-on-one last week at the Health 2.0 conference about the election, then moved on to MACRA and other pressing topics. The transcript below has been lightly edited.
HealthLeaders: Isn't it ironic that rising healthcare costs, the very thing that's making the economy leading up to this election so agonizing, is the one thing that they haven't talked about so far in the debates?
Bush: I think it's ironic beyond words. I believe that our healthcare system created Donald Trump.
I don't think it's because of healthcare. I think it's because of the checkbook impact of healthcare, and I even think the checkbook impact of healthcare wouldn't have created Donald Trump if people felt power over their healthcare, if they were buying that much healthcare and kind of showing off about it and enjoying it and feeling like they're living longer or their knees work better or something.
I don't even think that would do it.
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HealthLeaders: A high deductible does not power make.
Bush: A high deductible and a kind of a very powerless patient experience. Not even 'thank you' or 'we're glad to see you,' and remember most of us don't do anything with it. Ninety-two percent of us, maybe we have a baby or break an arm here and there, but we're not consuming anywhere near $565 per human per month.
HealthLeaders: We're just paying for it.
Bush: We're paying for 6% of us that are chronically ill and one and a half percent of us that are raging against the dying of the light in ways that we might not want to do ourselves if we could keep the money.
And that wouldn't even matter if it wasn't for the fact that our middle-class paychecks [are declining] and GDP is going up.
Unemployment's low, but the actual deposit into the bank account is declining, and it has been except for a couple years. I don't remember which ones, but the rest of them, those paychecks are smaller after healthcare and required benefits [are paid for put-of-pocket].
HealthLeaders: How do we galvanize healthcare executives to actually do anything differently than what they've been doing, because it seems to me that [whether you] call it meaningful use or call it MACRA or whatever, things kind of just continue as before. The regulators, when pressed, will kick the can down the road as they have now done with MACRA.
Bush: As they did with meaningful use 3.
HealthLeaders: So what is it going to take for our industry to change?
Bush: Innovation has always and will always happen from the outside in. There is such a thing as first movers. Mayo Clinic is the first institution that I know of that has started to detail its clinical decision support guidelines on Epocrates along next to the drug companies. It started in the past three weeks.
We're rewriting all of Epocrates [athenahealth's medical reference app for physicians] to allow every institution to be connected, to even let their charts be visible on ePocrates.
HealthLeaders: So are you turning it into a PHR?
Bush: It's basically a universal remote for EHRs that you hate to use, including athenanet.
Scott Mace is the former senior technology editor for HealthLeaders Media. He is now the senior editor, custom content at H3.Group.