In the 1950s, President Eisenhower started an interstate highway system to link our country, from Rhode Island to California. To this day, the interstate system remains the heart of our country's road infrastructure, supporting travel, commerce and transportation. This public investment paid off in long-term social and economic benefits for all Americans.
Health care offers a new opportunity to build a lasting national infrastructure that will -- like our interstate highway system -- connect individuals, create new economic opportunities and improve the quality and efficiency of our current system. That infrastructure is health information technology (IT).
Despite heated political debates on the future of our health care system, there is bipartisan agreement that health IT can be a powerful tool to transform and modernize the delivery of health care in our country. Health IT is about helping patients and their loved ones. Any patient who has a serious illness requiring multiple doctors understands the frustration of lost medical charts, repeated procedures, or having to share the same information over and over with different doctors and nurses. Health IT helps save lives now lost due to preventable medical errors, from incorrect diagnoses and needless infections to drug mix-ups and surgical mishaps. As important, health IT will support the use of the most successful treatments, so that we use best practices to narrow the wide discrepancies in the quality of care Americans receive.
These core principles -- helping patients, preventing medical errors, promoting best practices and improving quality -- are the reasons that health IT is featured in both the 2012 Republican platform and 2012 Democratic platform. Both parties recognize the long-term benefits from investments in health IT for our economy and for the health of the Americans we serve.
The U.S. is already moving ahead with the deployment of a strong health IT network. This movement was spurred by the federal investment included in the 2009 Recovery Act. It is supported by the smart delivery system reforms of the Affordable Care Act, such as paying for quality of care, not just quantity, and better coordination of care for patients with multiple illnesses. Thousands of practitioners and hospitals across the country are leaving cumbersome paper records behind and making electronic health records the new norm. In my home state, the nonprofit Rhode Island Quality Institute has emerged as a national leader helping doctors put information technology to work for their patients.
So what does this mean for you, as a patient? As I noted in a report earlier this year, health IT is at the heart of a growing movement to help improve the sustainability of Medicare, Medicaid, TRICARE and private coverage by improving the quality of care you receive while reducing the costs. In the long term, a robust health IT network will support personalized treatment that adheres to proven best practices, and adapts to your personal health circumstances. The time will come when, whatever illness you may have, for your body type and health history, there will "be an app for that" to keep you on your best path to wellness.
For all these reasons, I look forward to taking part in the seventh annual National Health IT Week, which began on Monday, September 10. This series of events highlights health IT developments, success stories and innovators. The breadth of the policy discussion and excitement among participants makes it clear that the national health IT movement is picking up steam and driving positive change in our health care system. Please join me in recognizing National Health IT Week as we work to build the technology infrastructure that will carry the American health care system into the future.
Follow Sen. Sheldon Whitehouse on Twitter: www.twitter.com/SenWhitehouse
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A Look Around The Bend At The Health Innovation Highway
http://www.fastcompany.com/3000943/look-around-bend-health-innovation-highway
1) If physicians are not engaged in the adoption, the whole mix grinds to a halt.
2) All of the healthIT in the world will not take the place of compassionate, patient-centered care.
3) Healthcare IT is not meant to be a substitute for sound clinical judgement.
4) Physicians need to get on board and realize that much of the Meaningful Use initiatives are the result of the IOM reports from 1998 and 2002. These are NOT hospital administrations ceding clinical control to the IT department.
5) Patients should be demanding their physicians be using Electronic Medical Records and electronic health data exchanges. They make data more accessible, improve the quality of care across the continuum of care, and reduce errors.
My background includes installing large computer systems that run corporations. I think there are problems in medical IT with too many companies with proprietary software. How cumbersome is it to transfer my records if I change doctors? What if I go to a doctor who sends me to a lab for blood work or an x-ray or a mammogram? With all the different systems out there, how does my information get transferred into my patient record. Those are just a few concerns.
Another issue involves the cost of maintenance and upgrade. There's the initial cost of purchase and implementation but then there's an annual license fee plus the cost of implementing periodic enhancements and major upgrades (just like Office has a version 4.0 and then has some enhancements and now we have 4.1, 4.11 and then we have a major upgrade and go to 5.0). Implementing an upgrade is like going through a mini initial implementation. Plus you have to train staff on any new features.
I'm not sure a lot of medical practices know what they're getting into. There a lot of work involved in an implementation and in maintaining and upgrading the system.
I do think there should be standardization because we need this software to talk to numerous insurers and providers. Standardization would help lower the cost. Most doctors offices and providers don't have a large IT staff to implement and maintain a computer system.
I go to a large medical center that has medical practices throughout the region. They've pioneered using computers for patient records (I wonder if it was done in-house rather than purchasing off the shelf). They are now reaping the rewards of having years of data available to do things like analyze outcomes and identify best practices. Because I can get all my medical care under one roof, I have a complete record and can access information like lab results.
As a patient I love it. I wouldn't want to go back to a doctor who has paper records or who even may be computerized but not to the point where I can access my records.
Electronic medical records lead Pennsylvania health system to better care, lower costs
http://www.emrindustry.com/index.php/electronic-medical-records-lead-pennsylvania-health-system-to-better-care-lower-costs/
2) The delivery system is fixed by using Peter Orszag's “Best Medical Practices”, interactive-electronic diagnostic and treatment workbooks and a smartphone. Here:
http://www.huffingtonpost.com/social/no_body/obama-affordable-care-act_b_1389760_144757327.html
References:
http://www.huffingtonpost.com/social/no_body/obama-affordable-care-act_b_1389760_144771932.html
Of course the diagnostic workbooks would come back with an efficacy, statistical prognosis and cost to the patients for all the different treatment options so they can make an informed choice.
3) Health care rebates for shopping around, positive living, etc. Similar to the way rebates work for car insurance. It would be based on the statistical normal cost of treatment for all the different therapies. It would also offer the choice of quality-of-life at the end-of-life.
4) Giving away the patents paid for by the taxpayer and then not letting Medicare negotiate prices is a sin. But the workbooks I mentioned in #2 could have registered steps in them that would allow a business model like a 900 number. Innovation is not limited to producing a pill but only a better outcome and could be patented.
5) Remove the health care industry anti-trust exemption.
I have had close, long-term involvement with treatment of chronic illnesses for different people, and I have never experienced a lost chart or a repeated procedure. I don’t see how IT could help with that kind of thing anyway. Medical mistakes and simple errors happen despite providers having thorough information at their fingertips. Even the most well-informed humans make errors.
And any doctor worth dealing with will ask patients to describe their illness and symptoms before jumping in to recommend treatment, no matter what the medical record says. When you’re sick, telling your story over and over again is part of the deal.
Promises of best practices, improved quality of care, personalized treatment and reducing costs don’t tell much. Those phrases sound very nice, like something from a marketing brochure, but they are meaningless.
What does this IT project actually do besides make our private health information accessible by millions more people? What’s the real purpose? Who is it really good for? Insurance companies? Doctors and hospitals? Are we going to pay billions for something that will put more money in the hands of providers, with no real benefits for us?
If there is some real benefit for us I'd love to hear it.
2) The integration of all clinical functions within these systems assures that the physician-ordered tests are processed, resulted, and reported on the right patient, reducing expensive re-work errors.
3) Maintaining active medical histories - including surgical histories, allergies, familial medical histories, and the like - allow proper targeted preventive care to be prescribed before a condition presents or, worse yet, becomes problematic.
4) Electronic physician order entry, particularly in hospitals, helps to reduce medication errors by 75 - 90%, by eliminating transcription errors, data entry errors, drug-drug interactions, and drug-allergy reactions.
5) The electronic medical record may be exported and either written to a disk or sent directly via a health information exchange, thereby assuring the next person to care for you has a complete, accurate health history.
I could go on, but am limited to 250 characters.
2. Hospitals are reporting the wrong test results for patients? And people think it will help to diminish the need for attention by alert, thinking people by deferring to a computer to catch errors? No thanks. Lose the computers; train better doctors and nurses.
3. “Prescribe targeted preventive care before a condition presents?” If people are well, why are they even in a doctor’s office? It’s not efficient to crowd an already crowded system with well people paying to be told don’t smoke, don’t overeat, exercise.
4. Hospitals order tests and such using computers now. This seems irrelevant to the subject of a big nationwide database with everyone’s private health information. They don’t need access to the world’s medical history to order drugs or tests electronically.
5. It’s good for your new doctor to know your health history. Unless your last doctor’s office burned down you can get a copy of your records and hand them to your new doctor.
I haven't read a compelling reason for this electronic records initiative. I don’t even know exactly what it entails or what it will cost. Only the sale pitch. The arguments for it are unconvincing, and unconvincing arguments are usually a smokescreen.
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Doctors pretty uniformly deny that record-keeping technology (which is what this comes down to) helps patients or prevents medical errors. Instead, they say, it turns them into data entry clerks who spend their time with a patient looking at a computer screen and filling out forms than listening to the patient.
Upgrading the medical records system may be the lowest hanging fruit to upgrading care and controlling cost.