Building a Strong Foundation for America’s Health Care System Through Health Information Technology

Valerie Manak contributed to this post.

Republicans and Democrats do not agree about many health care policies, but both sides believe that the effective use of health information technology (IT) is fundamental to a better health care system. On June 2, the Bipartisan Policy Center’s Health Project launched its Health IT Initiative with a series of policy leaders and on-the-ground experts – who spoke to a 250+ crowd at the Newseum – to demonstrate how the development and widespread dissemination of health IT will overcome many challenges confronting our health care system.

The Future of Health IT

Senators Tom Daschle and Bill Frist kicked-off the policy briefing, “Leveraging Health Information Technology to Build a Strong Foundation for America’s Health Care System.” Senator Daschle explained how expanding health IT would increase quality and lower costs, but he was candid about the challenges of full scale implementation, noting five barriers to widespread adoption:

1. financing;
2. transition and adoption;
3. interoperability;
4. lack of support; and
5. patient privacy.

Senator Daschle concluded that he had “every expectation in this transformational time that we can and will succeed with bipartisan support.”

Senator Frist emphasized the everyday benefits of health IT to consumers and providers of health care. He talked about how health IT / telemedicine enables a doctor in Boston to quickly diagnose something uncommon to that area – Rocky Mountain spotted fever – by consulting with a physician from Tennessee where the diagnosis is common. Senator Frist noted that individuals are increasingly mobile – the best care requires health information to be equally as mobile.

Dr. Don Berwick, Administrator for the Centers for Medicare and Medicaid Services (CMS), delivered the keynote address, discussing the urgency of developing health IT to make the delivery of health care more efficient. He told a poignant story about a patient’s experience with a knee replacement. A routine procedure that should have been followed by an ordinary recovery turned into a year-long ordeal fraught with medical errors due to a lack of communication and information sharing at each point of care. Dr. Berwick said that if the potential of health IT was realized when this patient needed her knee replaced, her primary care doctor would have been able to recommend an appropriate surgeon, her surgeon would have had the latest information from the myriad of clinical trials that occur on a daily basis, and all of her caregivers would have been better equipped to act in concert. In sum, Dr. Berwick concluded, health IT “takes the best we know and make it available to anyone all over the nation.”

Realities of Implementation

Following Dr. Berwick’s address, Russell Branzell of Poudre Valley Health System, Soma Stout of Cambridge Health Alliance, and David Voran of Heartland Clinic engaged in a lively discussion moderated by Ceci Connolly of the McKinsey Center for U.S. Health System Reform. They shared their organizations’ experiences with the challenges of adopting health IT into their daily operations.

• Poudre Valley Health System (PVHS) created an initiative called “Community of Care” to provide health IT to the whole system –including small physician offices. According to Mr. Branzell, physicians have access to records “anytime, anywhere, any place,” with systems available in physician homes and on mobile devices. To overcome legal barriers to offer these systems to physicians directly, PVHS set up Innovative Enterprises, a nonprofit structure that offers HIT to all physicians at a fraction of the cost.
• Dr. Stout talked about how health IT promotes a culture of seamless, coordinated care across all disciplines. She relayed a story about a patient’s diagnosis of cancer that was immediately shared among the patient’s primary care physician and specialists, which was then discussed as a team before considering options with the family. By sharing information between caregivers, Cambridge Health Alliance physicians no longer act in isolation, but instead provide cohesive, patient-centered care.
• Dr. Voran shared how imaging technology allows doctors to better engage with and educate patients. At Heartland Clinic, physicians use touch screen monitors that patients can push the button to capture photograph of their inner ear or tonsils – which helps them understand a diagnosis – or lack thereof.

Ms. Connolly asked each panelist what kept them up at night about health IT implementation.

• Dr. Voran warned that most email consultations are not reimbursed by payers, discouraging the adoption of e-consults.
• Dr. Stout worries that doctors have trouble collaborating when their health IT systems are unable to communicate with each other. She suggested that policymakers adopt a coherent approach to interoperability.
• Mr. Branzell said that the pressure to implement health IT will result in unusable systems, and called for greater outreach to smaller, less advanced practices.

Next Steps

The BPC released a new report, The Role of Health IT in Supporting Health Care Transformation: Building a Strong Foundation for America’s Health Care System, to provide insight into the current landscape of health IT and make the following recommendations for moving forward:

• Coordinate efforts in delivery systems reform, payment reform, prevention, health insurance reform, and “meaningful use” of health IT so the resulting systems are naturally integrated;
• Utilize lessons learned from early experiences with health IT in the continued development and implementation;
• Engage with the consumers of health care through new technologies; and
• Draw on the public-private partnership to provide outreach and support for those adopting new technologies and organize a strategy to encourage increased health information exchange.

After the event, the new Task Force on Delivery System Reform and Health IT held its first private meeting to decide next steps. The Task Force, led by Senators Tom Daschle and Bill Frist, is comprised of 24 experts in the health care sector, including David Blumenthal, former National Coordinator for Health Information Technology.