Posted on 05/02/2004 10:24:52 PM PDT by neverdem
WASHINGTON — Health care policy is a partisan minefield, with Democrats and Republicans differing on everything from Medicare changes to malpractice reform to strategies for covering the uninsured. Yet, while the two of us have been on opposite sides of most of those battles, we both believe that America's health care delivery system must be transformed. To begin that transformation, we should heed President Bush's call last week for widespread adoption of electronic health records. As the president noted, "The 21st-century health care system is using a 19th-century paperwork system."
The archaic information systems of our hospitals and clinics directly affect the quality of care we receive. When you go to a new doctor, the office most likely has little information about you, no ability to track how other providers are treating you, and no systematic way to keep up with scientific breakthroughs that might help you.
The results are predictable. For example, approximately 20 percent of medical tests are ordered a second time simply because previous results can't be found. Research shows that 30 cents of every dollar spent on health care does nothing to make sick people better. That's $7.4 trillion over the next decade for duplicate tests, preventable errors, unnecessary hospitalizations and other waste.
Not only do these unnecessary costs contribute to skyrocketing insurance premiums, but the lack of good information makes improvements in quality and efficiency nearly impossible. Every year some 98,000 Americans die in the hospital from preventable medical errors, like receiving the wrong medication. Nearly half of patients do not get all the treatments or tests that should have been administered. This is usually not the fault of doctors, nurses and other health professionals — these problems persist because of systemic failures stemming from the absence of good health information.
The problem is not that we need innovation: existing technology can transform health care just as it has nearly every other part of society. If all Americans' electronic health records were connected in secure computer networks that safeguarded patient privacy, health care providers would have complete records for their patients, so they would no longer have to re-order tests that have already been done.
In addition, most referrals and prescriptions are still written by hand; computerized entry would eliminate errors caused by sloppy handwriting. Computer programs can warn doctors of possible adverse drug and allergy interactions, and remind them of new advances in evidence-based practice guidelines. Patients could also have easier access to their important health information, allowing them to be active participants in their own care.
Moreover, in a post-9/11 world, electronic health information networks would allow doctors, hospitals and public health officials to rapidly detect and respond to a bioterrorism attack.
Unfortunately, health care providers are famously stingy investors in information technology. The primary reason is that when new technology reduces the duplication, errors and unnecessary care, most of the financial benefits don't go to the providers who generate the savings, but to insurers and patients.
Therefore, widespread adoption of technology will depend in large part on federally organized public-private partnerships. Treasury dollars could help bring providers in a particular part of the country together to map out plans for a regional health information network, and to divide up the costs and the savings fairly between them. Medicare could sweeten the pot by reimbursing providers for money spent to use electronic health records connected to a regional network.
New information systems would also allow us to reinvent the way providers get paid. Right now, most doctors and hospitals get paid by the procedure, regardless of quality. They get paid even if they make mistakes, and then paid again to fix the mistakes. And under our current perverse payment practices, when providers improve quality and efficiency, it frequently hurts their bottom lines.
New information systems would give us nationwide data to develop standardized performance measurements for providers, so anybody can get an apples-to-apples comparison about how good a job a doctor or hospital does. This data would also allow Medicare and private plans to restructure their reimbursement practices, so that the market would drive competition in quality and value among hospitals and doctors, just as in most other fields.
Politicians like to say that the United States has the best health care system in the world. Actually, what we have right now is the best medical talent, technology and facilities in the world — but the system that delivers our care is badly broken. Democrats and Republicans should agree that moving American medicine into the 21st century is not only an important goal, it is also literally a matter of life and death.
Newt Gingrich, a former Republican speaker of the House, is the founder of the Center for Health Transformation, a for-profit organization. Patrick J. Kennedy, a Democrat, is a representative from Rhode Island.
Merely assuring the security of this patient information isn't going to prompt patients to divulge embarrassing personal medical history that may go out on the internet.
Does moving to 21st Century health care mean integrating with Canada now?
Hold on to your wallets!
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