Healthcare Reform Needs IT Now

Michael Vizard

There is a great debate going on in this country over the future of healthcare. No matter what side of that debate you may personally be on, just about everybody agrees that cutting the cost of delivering healthcare in this country is a noble goal. Clearly, one of the keys to achieving that goal is going to involve leveraging IT to create more efficient business processes.

And yet, the IT community in the healthcare sector appears to be largely silent on the subject of healthcare reform, which is a great shame because in the absence of some real leadership on the issue, politicians are debating the merits of various top-down policy initiatives that to one degree or another are deeply flawed.

Vendors such as Cisco and IBM are pretty vocal about the potential value of IT in the healthcare sector. But the extent of the participation in the healthcare debate by the IT people that work in this sector seems to be confined to the setting up of a new Twitter account by the Healthcare Information Management and Management Systems Society (HIMMS) and a single appearance on Fox Business News by HIMSS executive vice president Carla Smith.

The rest of the IT activity seems to be focused on keeping a running tally of the Federal stimulus money being allocated to healthcare initiatives under the American Recovery and Reinvestment Act (ARRA). Unfortunately, one of the cornerstones of that effort, the creation of electronic healthcare records (EHR), is already foundering.

At the moment, healthcare reform in the context of IT resides in the hands of a Health IT Policy Committee created under the auspices of ARRA. The committee will make a recommendation to the Department of Health and Human Services, which is suppose to deliver its final recommendation by the end of the year. But already the committee has signaled that healthcare organizations receiving ARRA funding must have some form of "meaningful use" of EHR in place by 2011. The definition of "meaningful use" is deliberately vague, so most people are interpreting that to mean a pilot project. Worse yet, there's no indication that "meaningful use" actually means sharing records with other healthcare organizations, so what we should expect to see is little more than glorified extranets linking a single healthcare organizations with its suppliers and insurance providers. All in all, this is a far cry from what many people assume is a new national priority because at the rate we're on we might actually be able to show some meaningful business results from all this Federal stimulus spending starting in 2013.

Worse yet, healthcare organizations are lobbying for more time to implement EHR. They argue that EHR represents a massive change in their business processes that will take years to implement. Just about everybody concedes that the technology is readily available to make this happen. What they are really saying is that the will to capitalize on the technology to reduce costs and improve healthcare is not really there.

Now to put that in some perspective, former Secretary of the Treasury Paul O'Neill estimates that there is $1 trillion worth of waste associated with healthcare processes. A little quick back-of-the envelope math shows that if we could cut that waste by 20 percent, that would result in a number that is still five times larger than what President Obama has called for in savings to pay for various healthcare proposals. Whether you agree with the President's plan doesn't matter. What matters is that instead of focusing on making the healthcare process more efficient in order to cut costs, politicians have turned the debate over healthcare into a political circus that is most likely going to result in more harm than good.

One of the principal tenets of healthcare is to do no harm. By sitting on our collective hands, however, are we about to let harm happen? And if so, what is the IT community really willing to do about it? IT people complain all the time about not having a seat at the table. In the healthcare debate there is an open chair at the table. But in this debate seats are taken, not given.

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