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The business of healthcare at the physician/patient level is 10 to 20 years behind in technology. All patient records are recorded on paper. Comparing lab results and the diagnosis of your physician is a manual operation that takes several days to process. The insurance company charging premiums gets a claim that has been handled by not less than four pairs of hands who each stake a claim to the financial outcome of your office visit. Combine all this inefficiency, and it’s no wonder physicians collect 63 cents on the dollar and are satisfied. This is unacceptable to every other business in the United States. Why do we accept it in healthcare?

We as Americans have to recognize the absurdity of driving a car that will monitor all of its internal systems and alert us to any failings, yet we refuse to channel our health information into an IT network that would literally save lives. We, as consumers, allow our local grocery store to provide us with a frequent user card that attaches all of our banking, consuming, functioning records on convenient magnetic cards. However, we allow a small faction to convince us healthcare IT is a very bad idea because someone might have access to our lifesaving healthcare records. We have the technology at our disposal.
Why can we not reason our way past utilizing it to increase our quality of life. I find it an outrage that we can track an 8-year-old with a cell phone anywhere in the world down to a meter square, yet we cannot track a Medicaid recipient from one pharmacy to the next at less than 100 feet apart.

So do the costs outweigh the benefits, or is the cost as prohibitive as some would have you think? Health IT would eliminate costly duplicate testing. If you were given an x-ray in a hospital on Monday and your physician needed this same diagnostic information on Tuesday at a different location, chances are the test would be duplicated in order to speed access to information. As a consumer are you aware you most likely will pay for number two out of pocket because your insurance company cannot justify the same test resulting in the same outcome in a 24-hour period? Connecting healthcare information alleviates this problem, and saves an estimated $50 billion. The same technology that instantly tracks your ATM card usage can link doctors to secure and complete patient information, history, and prescription usage. We see 98,000 deaths each year caused by medical errors that would be drastically reduced if healthcare providers had access to comprehensive patient information. The U.S. Department of Health and Human Services reported that electronic medical records would reduce the cost of healthcare by 30 percent or $690 billion annually.

Health IT is available to the physician that literally pays for itself in generally less than a year. When you consider IT eliminates the disparity between 63 cents and one dollar, or 37 percent, a physician already has a handsome return on investment. When paper changes to electronic charts each physician saves over $15,000 per year or an estimated $300 billion nationally.
Add to these the elimination of duplicate tests, lost charts, lost charges, coding, diagnostic testing, and so on, we need to wake up and realize the reality is we cannot afford to put this off any longer. Current technology tracking illegals in the system saves $250 billion per year. Health IT billing private pay instead of Medicare/Medicaid saves $75 billion annually. Does health IT pay for itself, and then some?

The solution lies in technology but don’t be fooled as all technology is not created equal. We must first define the best solution. A health IT system which is interoperable and fully integrated provides the best economy of scale as well as the most efficient system available. However, this is where we cannot afford to be fooled. Systems that are fully integrated operate off of a single database eliminating the need for keying in redundant information such as insurance carriers and what they will pay for service. Total integration provides the most functionality in one comprehensive system and eliminates costly and deadly mistakes. This type of system is very rare but readily available today and is surprisingly cost effective, even for the single practitioner. Most technology offerings in healthcare today have been built separately, and then pieced together. This positioning of systems is called interfacing but they would have you believe their systems are integrated. These systems don’t always connect information among patient records, laboratory, pharmacy or insurance provider.
When they do connect the information through interfacing, it becomes a costly system to maintain as each interface must be maintained and updated each time a change is made in any of the modules. A physician will be frustrated with the cost and the inconveniences of tracking what goes where and eventually not use the system. Even the most expensive, highly marketed systems on the market have taken three and four different software systems and interfaced them together providing an inefficient costly form of IT.

Just because a system is CCHIT-certified does not mean it’s an efficient effective solution for healthcare reform at the patient/physician level. If you are currently utilizing a clearing house or paying a service to scrub your claims before they reach the insurance company you are on old, expensive technology.

We must take our experience and knowledge and put these to good use rather than just throw money at healthcare IT reform. A foundation of technology must be initially implemented at the state level that will connect to the national level. When building a house, one must start with a firm foundation that will support short and long-term strategy. States with grants must consult with IT experts who will make the right choices and think beyond the borders. Most states are starting with a Regional Health Information Organization (RHIO) or information highway that supports interoperability. This is the ability to easily connect all information no matter its platform.

Secondly, states must connect information at its source — the physician, hospital, diagnostic center, laboratory and pharmacy — into concise readily available information so that the patient and treating physician are the benefactors. Information connected at the source to the information highway then the national system, provides the building blocks for maximum benefit at the national, state, local and most importantly at the physician/patient level.

The solution to reforming our national healthcare system does not lie in the dismantling of the most advanced healthcare system in the world in order to provide socialized medicine to the masses. It lies in utilizing the most advanced information technology in the world to the everyday business of saving lives. We must start with 21st century technology implementation so that it can be about the business of managing 21st century medicine.



July 2008

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