Health Affairs does a really great job addressing policy issues in healthcare and their latest issue once again focuses on HIT. I will review a few of the web-exclusive perspectives presented over the next week and will comment on each separately.
Since Dr. Brailer taught me the foundation that is the basis for my opinions about health information technology and exchange, I will start with his thoughts on presidential leadership and health information technology. At this point, it is important that I remind readers that I come from the perspective of a hospital administrator who has worked closely with physician providers (many small business men and women) throughout my long career.
Dr. Brailer does a really nice job reinforcing the fact that it doesn't matter if you are a democrat or a republican, what is important is that we apply health information tools to improve healthcare. He describes our current goal for widespread adoption of EHRs within the decade as a torrential rate in a glacial industry and his assessment is so accurate. That is why we should take seriously his cautions and advice unless we want to really jeopardize the tremendous progress that has been made over the last several years.
Dr. Brailer highlights the importance of portable health information, not just throwing technology at broken processes. Previously, Congress didn't get it and Bush had to ensure that we stay on the right path. Today, it looks like Congress still hasn't gotten it and our prayer is that Obama will get us back on track. Investment in interoperability using the technology tools will stimulate the economy, but investment solely in the technology will only lead to more of the same inefficient and ineffective silos of electronic of health information that don't always bring that information to the point of a patient's care.
If you read the chapter I wrote for the HIMSS RHIO Guide titled "Stakeholders, Collaboration and Driving RHIO Formation" you will understand the importance of balancing private and public leadership. Interoperable health information exchange isn't something the government nor the private sector can do alone. We will be most successful if we truly collaborate for the good our healthcare consumers and put aside our individual interests (ie. the people who elected us to office or our company's product.)
"Fear of government prosecution and liability" are words Dr. Brailer wrote about what providers feel about sharing health information. I don't know if Congress doesn't understand, but I do know that this fear sometimes paralyzes a healthcare organization and causes delays in needed change because administrators just don't want to go to jail. We all know that you have to take risks (with some amount of calculation) to grow and dramatically improve an organization's efficiency and effectiveness. However, healthcare is the most overly regulated industry and the barrage of unfunded mandates with stiff penalties causes delays while expensive legal council and hospitals tip toe through the often confusing and conflicting legislation. Patient information must be shared to improve healthcare. Portability with privacy is a slippery slope, but balance must be found if we are truly to improve healthcare and lower costs.
Dr. Brailer is correct that many of the larger healthcare organizations, especially if they are both a payor and provider, are implementing HIT tools because it is quickly becoming a cost of doing business. They have a value proposition. However, a small rural hospital struggling to breakeven or realize modest profits so they can afford to replace old outdated equipment or add services to address growing patient needs is going to have a much tougher time affording a new EHR. More does have to be done to reach out and bring these organizations along. I suggest a component that provides additional assistance to the hospitals treating the 20% of their community's population that account for 80% of the costs and a reward for those operating efficiently but who still have thin margins because of uncontrollable reimbursement issues.
Lastly, real healthcare reform will stimulate the economy because the cost savings realized will allow businesses to invest in growth, the government to expand important programs, and consumers to have a little more money to spend on their daily living. Lets reform healthcare using the interoperable information technology tools that are available today and in the future!
The goal for widespread adoption of EHRs within the decade is great!
Kevin
Posted by: emr software | August 03, 2010 at 08:06 AM