Kaiser Permanente was recently highlighted in a New York Times article, "The Face of Future Health Care." Kaiser has been recognized as a leader in the type of health care organization the Affordable Care Act wants to advance, as a model for combining insurance, hospital and doctor care. They also have a jumpstart on using technology in maintaining patient records and coordinating care. While the Affordable Care Act is comprehensive and will hopefully bring about positive changes for the country's health care system, it remains a contentious and challenging plan to fully understand. With that in mind, I decided to take a look at some tech aspects of ACA and the health care industry.
My initial opinion was that electronic medical records (EMR) sound great, and in many ways, I still think that's true. After filling out long forms at our primary physician's office for my daughter, we had to provide all the same information again when referred to a specialist. I've done work with a clinic that treats some challenging cases and those patients have, on average, seen 14 other doctors. You can imagine the size of those medical charts. Having patient records that can be brought up from a central database and updated easily either in the office or at home by the patient seems like an efficient use of technology, if not daunting to institute.
Applications for using electronic records in health care vary widely at the consumer and industry level, but most focus on saving time and money while increasing the quality of care and efficiency. In a recent HuffPost blog, Eduardo Garcia looks at whether the switch to EMR is actually reducing costs and public opinion of the HITECH Act that provides funding for health care IT. He quotes a survey from PwC's Health Research Initiative that found four out of 10 voters don't favor federal investment in health care IT:
Consumers see the value of research and development but not health information technology investments -- consumers in the HRI survey supported reductions in HIT spending as a way to trim the deficit, but want to protect R&D ... The industry faces a challenge in articulating the case for technology investment.
Large, small, mid-sized and start up companies are developing and marketing applications that specifically address issues related to research and tracking, combining R&D with technology advances. GoMed is a small start up with a mobile platform to record data in real time, helping with compliance and reducing costs in clinical drug trials. PSKW became a leader in the copay industry but also offers comprehensive tracking and analytics for pharmaceutical companies leading to better communication with patients. In diabetes research, companies like Medtronic have nanotechnology advances on the market and in the R&D phase for improved insulin release and tracking.
These are just a few examples of an industry challenged to continue expanding technology use. Developing best practices for using this information requires consumer, industry and government backing. Some physicians have expressed dissatisfaction with new digital methods for recording patient data. In some cases, they complain it is time-consuming data entry work. Other physicians feel it takes away from the personal contact with a patient when the computer requires so much of their focus. ACA is focused on getting doctor's offices up to speed with EMR and offers financial incentives for doctors who switch over. Penalties will be levied against doctors who don't start using EMR in their offices. Figuring out where technology works best to improve health care and reduce costs will take some time. I can see how data mining, alerts to patients, a central database with standard patient information and other innovations can accomplish these goals. It remains to be seen if Republican pressure to repeal ACA will be successful or if portions of ACA will be slowly chipped away. The ACA isn't a perfect plan but if fully enacted offers a chance to make changes to the American health care system. Understanding the role technology plays will be an ongoing discussion with advances in technology and its creative application potentially improving care and reducing costs.
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