I’m at the Arizona Health-e Connection summit on deploying health information technology. Arizona is the first state to have a roadmap to transition its citizens to electronic medical records.
There’s a lot of transitioning left to do and a lot of thinking about how to do it, but for the past year I’ve been playing on the periphery of the effort, serving on various committees that are doing some of the thinking. To me, it seems the progress is slow, but as I sit here in this overflowing room I realize many people are committed to the process, so it will happen. The Governor is driving it, and she’s a breast cancer survivor herself, so she has a personal care here. I’m sure she started this whole drive by saying “what kind of health care do I need and deserver for myself and my loved ones,” and facing the fact that we don’t have it in Arizona – or anywhere in America.
Clearly, information technology can transform how we deliver health care. Everyone who has ever logged on to a computer knows it. But now there are several drivers for health IT adoption sooner rather than later: rising costs, awareness of the substantial benefits, administrative leadership, and the strong endorsement of business.
Probably because of the state’s rapid growth and the influx of emigrants from out of the state and out of the country, we have a strong partnership between the state, major employers, and health care organizations. AHCCCS, our Medicaid system, has received a $12m grant to e-healthify the records of its million patients. Once it is done for AHCCCS it will be easy to do it for everyone else.
The state also provided a grant to rural communities to “e-healthify” themselves.
Medical errors kill more people per year that breast cancer, aids, and motor vehicle accidents. In Arizona alone, we have $31m in unpaid emergency care costs. Tucson Medical Center alone loses $4m annually. Only 10% of providers use EHRs that are certified by the government for base level interoperability and functionality – never mind decision support.
The speaker from the Office of National Healthcare Information Technology (ONCHIT) is now telling us that the position of his agency is that the health care system isn’t broken. Rather, we don’t have a system for health care at all, and because it’s not systematized, it sucks. We have an industry sector, but it’s not yet automated, and thus not optimized. Kind of like the days before manufacturing automation.
Healthcare IT isn’t about technology, it’s about care, just as ERP systems aren’t about technology, but about supply chains. Health care has no good “supply chain” or “demand chain.” Every other industry sector does. Thus, health care does not deliver its product on a just-in-time basis to a customer whose needs it already knows. Wal-Mart can do this. So can health care.
The federal government has a plan to be at electronic health records by 2014. It has a number of work groups: consumer empowerment; chronic care; biosurveillance; and EHRs. Across those work groups is a group on quality, and another on confidentiality and security.
A good system would bring together electronic health records (provider), personal health records (patient), and public health information(payer or government). Amazingly, the consumer will probably adopt the technology first, and drag the providers along.
Fundamental to all this is standards (for security, data, and technology) that will create an interoperable system.
{ 4 comments… read them below or add one }
Since I use to be in health care, I could go on and on about this matter. However, I will try to stick to the points Im most passionate about.
“Rather, we don’t have a system for health care at all, and because it’s not systematized, it sucks.”
I couldn’t agree more. It does suck! Individual offices have their own system but no one is talking to each other. In the offices that I have worked in, their systems are flawed due to the demands of productivity. Lets face it, health care has turned into a production line with emphasis placed on quality care yet no one has time.
With that said, a universal electronic charting system would be epic and needs to be mandatory.
The only main problems I see are the sharing of xrays, the time required for learning, the need for updated computers and server crashes. Im sure there are a half dozen more. The problems mentioned above have solutions that are costly in currency and care. In the long run, a new system will prove beneficial for all.
The solutions-
x-rays- either send the xrays with the pt or make sure the referred office has the technology to accept the xrays digitally and quality print capabilities.
education- mandatory CEs and introduction to medical students.
computers- provide information on companies that lease computers.
server crashes- print out page overview of pt chart a couple days prior to appt. Multiple servers from different hosting companies backed up frequently.
Thats my $0.25. If you require an advocate, Im here for you Hardaway! Also, Josh and I were thinking about developing a system very similar to what you are proposing. We thought about it a couple years ago and haven’t executed obviously. You may have sparked the flame that will get us moving on it or writing the spec and having it built. Id like to hear your thoughts further.
Don’t write it, Sally. There are plenty of them out there. They just don’t get adopted. The change management process for the workflow, however, is daunting, and the user interfaces are less than desirable :-)
Speaking of Health Care and Arizona, what is being done about Valley Fever. It has become an epidemic and no one seems to care.
see http://www.valleyfeversurvivor.com
Over 50% increase in reported cases for the past 2 years in a row. Remember most cases get misdiagnosed or unreported.
Thanks
I had no idea there was such a great increase. Where’s the publicity? It must be because of the influx of new people into the state who do not have immunities.