Dr. Paul Grundy Headshot

Smarter Healthcare: Let's Pay Doctors To Keep People Healthy

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As a medical doctor, I'm concerned about many aspects of the changes taking place in heath care.

But I'm also excited, because we have the opportunity to make health care a lot better. It's a chance to change to a system of keeping individuals healthy, rather than performing procedures for payment. We can improve individuals' health by creating a smarter health care system that uses comprehensive information technology.

Things need to improve. U.S. health care spending has risen sharply, adding up to nearly $2.6 trillion in 2010, which is 10 times more than we spent in1980 and more than 50% higher than any other country. The costs threaten to make the U.S. uncompetitive.

And all that spending isn't buying great results. The Commonwealth Fund's third national health care scorecard last year found that the U.S. ranks last out of 16 developed countries when it comes to deaths that could have been prevented by effective medical care.

One reason is that the U.S. is behind in information technology systems for health care, according to the Commonwealth Fund's research. Even though the U.S. is the world's leader in computer systems and software, our huge health care system lacks sophisticated electronic systems.

The nation's health care system has had difficulty in developing seamless interaction among computer systems because of multiple physicians, hospital systems, government and private insurers. Rivalries among payers and suspicions by care-givers sometimes discourage open sharing.

The situation needs to get better. And we're talking about how to do so at the Healthcare and Information Management Systems Society Conference Conference, which is holding its annual meeting in Las Vegas now through Feb. 24.

The push to adopt electronic medical records by 2015 could bring big improvements. When a comprehensive record is accessible to any doctor who sees a patient, the result should be fewer unnecessary tests and fewer cases of prescribing medicine that could dangerously interact with a patient's existing prescriptions.

The creation of regional health information exchanges will also allow better sharing of clinical health information. After all, 90 percent of healthcare is delivered locally.

Patients must also become part of the information stream. There are plenty of easy-to-use, low-priced monitors for blood sugar and blood pressure. Connecting patients' information to computer systems could provide much more detailed information about chronic conditions.

If doctors were paid for keeping patients healthy rather than for office visits, they would have more incentive to encourage remote monitoring. They might find it cost-effective to e-mail with their patients.

New technology that can interpret the content and context of human language and analyze massive amounts of data will help. IBM Watson was developed as a sophisticated question and answer system to compete on Jeopardy! But now, IBM Watson is at work in healthcare.

The nation's largest health insurance company, WellPoint, is working with oncology experts at Cedars-Sinai in Los Angeles on a pilot. The system could even help doctors determine which treatment methods are covered by a patient's insurance plan.

As we change the health system, I hope that we won't lose the great things about American medicine. We as a nation lead in medical research. Many patients in the U.S. have deep relationships with skilled, caring physicians. We don't want to lose the best things about health care in the U.S. But being smarter about securely sharing health information could make health care more effective in its primary mission. It will make people healthier.

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