Healthcare Reform with Sound Information Technology

Written by: Ge Z on Jun 22, 2009 10:16 AM EDT

The substantive debate on the healthcare reform is in full swing and one of the center themes is the public option. President Obama wrote recently, "I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest." The latest NBC/Wall Street Journal poll shows strong, 76%, public support for public option (1). This is about essential choices and competition for accessible, affordable, and quality care; this is also about improving transparency, efficiency, value, and outcome. As a crucial component of the ongoing reform, sound Healthcare Information Technology (HIT) can be instrumental in realizing these objectives in a timely manner as the new healthcare system is been defined and will soon be implemented.

The new national healthcare system with the public option will facilitate the coordination and standardization of HIT, clear lacking of which at the present is delaying and denying the broader benefits of myriad of well established information technologies from the majority of payers, doctors and patients alike. Among the exciting new derived capabilities, HIT will become interoperable, and serve as the platform for reliable comparative effectiveness study to lower cost and achieve better outcome, much more effective than relying on the existing dysfunctional silo based approaches.

Today, any patient who seeks a second opinion, or moves from one city to another, often must request, pay, and carry his or her medical history and diagnostic images along. Another huge waste in healthcare expense today is redundant tests due to lack of ability to record, store, transfer, and compare previous obtained results promptly and safely. Without precedence, the recently enacted economic stimulus bill has committed a total of $19 billion to promote the adoption and use of HIT and especially electronic health record (EHR) by all doctors and patients across this country by 2014. The potential to promote prevention, reduce medical errors and health disparities, cut overall costs, improve and advance the delivery of patient-centered medical care is enormous.

Crucial to improving the health and care of Americans, HIT implementation face significant challenges. Few U.S. doctors or hospitals — up to 17% and 10%, respectively — have even basic EHR, and there are significant barriers to their adoption and use: their substantial cost, the lack of short term financial return from investing in them, the technical and logistic challenges involved in installing, maintaining, and updating them, and broad concerns about the privacy and security of electronic health information. The Office of the National Coordinator of Health Information Technology, led by Dr. David Blumenthal, at the Department of Health and Human Services is now creating a strategic plan for a nationwide interoperable health information system. Health information technology has a critical role "because it is a manager of information—and we are above all in the health care industry about using information to make decisions. Anything we can do to make the management of information more effective to get better information to the point of key decisions at the right time is going to ultimately improve the quality of those decisions and the products that our health care system produces." said Dr. Blumenthal. For more on the initiative please see his article(2).

Furthermore, the advance of health IT and payment reform should be implemented in close coordination, reinforcing each other. The quality metrics desired and designed to power payment reform should directly inform the definition of "meaningful use" of HIT. In turn, the data collected via the spread of "meaningfully" HIT usage should help power the development and refinement of reformed payment methods. A strong collective commitment to and demonstrable progress toward payment reform should help decide the business case for accelerated HIT adoption and optimum application. Congress can facilitate the coordination of the payment reform and the HIT program by formally linking the two components and requesting regular reports on their integration and joint execution. The combination of the two key efforts is significantly more likely to promote care delivery innovation and health improvement than either will on its own (3).

As a success case described by Phil Longman in "Best Care Anywhere" (4), the Veterans Administration has already developed a comprehensive EHR system for patients, medicines, nurses, and doctors—all based on open-source technology that can be refined and improved in the public interest. This should be the working model for the efforts underway at HHS. Another example, the Mayo Clinic in Minneapolis has also effectively leveraged HIT to incorporate systematic data-driven best practices to reduce costs and improve outcomes (5).

The dire economic woes have launched an unprecedented federal effort to modernize the information infrastructure of a sick health care system. It is now up to the government and the nation's health care professionals and hospitals to turn this true opportunity into dramatic improvements in the health and care of all Americans. In the days and weeks ahead, healthcare reform will remain on the center stage. Its outcome will determine the future of the health of the people and the health of the nation in the many years and decades to come. There is no doubt that the Healthcare IT initiatives being implemented right now will help enhance, enable and empower the success of this historical reform. Healthcare, as a public service, can and should only be better, much better, from here on.


New NBC/Wall Street Journal Poll Shows 76% Support For Choice Of Public Plan
http://www.huffingtonpost.com/2009/06/17/obama-boost-new-poll-show_n_217175.html

Stimulating the Adoption of Health Information Technology, by David Blumenthal
http://content.nejm.org/cgi/content/full/NEJMp0901592

A Historic Opportunity By Todd Park and Peter Basch
Wedding Health Information Technology to Care Delivery Innovation and Provider Payment Reform
http://www.americanprogress.org/issues/2009/05/health_it.html

The Best Care Anywhere: VA health system and electronic records pay off, By Philip Longman
http://www.washingtonmonthly.com/features/2005/0501.longman.html

The Electronic Medical Record at Mayo Clinic
http://www.mayoclinic.org/emr/<!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> </w:Compatibility> <w:DoNotOptimizeForBrowser /> </w:WordDocument> </xml><![endif]--> <!-- /* Font Definitions */ @font-face {font-family:Verdana; panose-1:2 11 6 4 3 5 4 4 2 4; mso-font-charset:0; mso-generic-font-family:swiss; mso-font-pitch:variable; mso-font-signature:536871559 0 0 0 415 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:""; margin:0in; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman"; mso-ansi-language:RU; mso-fareast-language:RU;} @page Section1 {size:8.5in 11.0in; margin:1.0in 1.25in 1.0in 1.25in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman";} </style> <![endif]-->

Healthcare Reform with Sound Information Technology

Tags: