While much of the current health-care reform talk is centered on controversial issues, there is one factor that should not elicit much controversy but can do much to truly reform our health-care system and make it work better for all Americans. That factor concerns improved health-care data collection, maintenance, and analysis, including better partnerships between patients and their health-care providers regarding data.
Earlier in the health-care reform discussion, President Barack Obama spoke a great deal about the need for more efficiency, security and usability with regard to patient records, health-care provider reports, and many of the other data created in the course of delivering health care to hundreds of millions of Americans every year. In the effort to get some measure of health-care reform enacted in the near future, we must work hard to not lose sight of the need to significantly reform the national health information system.
Tempting though it might be for some to say that cleaning up the health information system would result in negligible, almost “cosmetic” savings that really won’t account for much, the billions of dollars that a more efficient health information system could potentially save this country annually are much more than cosmetic.
Some $21 billion might be saved yearly
Findings from just one study released in November 2008 by the Center for Information Technology Leadership indicated that some $21 billion might be saved each year if at least 80 percent of people used personal health records. These records are web-based systems that would permit patients to manage their medical data (in close concert with their health-care providers) and then use the data to improve their health and make better health-care decisions. This doesn’t even count the lives that could be outright saved as a result of better management of health data and decreased duplication of tests.
It’s easy for even casual observers to see that there is a great need to improve our health information system. Think of how often we see glassed-in health-care-provider offices, large filing walls of color-coded manila folders filled with paper patient records placed right behind the receptionist desk and in full view of ordinary people and potential criminals alike.
Think of the serious consequences that occur when a person, otherwise healthy but allergic to a few commonly used medications, is involved in an accident far away from his or her home that renders the person unable to speak. The health-insurance card gives no clue as to contact details for any personal physician, nurse practitioner, or pharmacy, nor any information regarding allergies, thus possibly making useless and even deadly the care rendered by the EMTs, physicians, nurses and technicians working to save the individual’s life.
Or consider times of pandemic (such as that which we are witnessing with H1N1 infection), when family-practice physicians and nurse practitioners across several sparsely populated counties might see a number of cases of the same disease, with all of the same symptoms. They are ready and willing to work with state epidemiologists and each other to see if a serious trend is emerging, but their data systems make it difficult to easily and quickly transfer and then analyze the non-personal patient information they’ve collected.
Efficiency, security, usability
For these and any number of other reasons, we need to do a great deal to make our nation’s health information system more efficient, secure, usable, and informative for patients, insurers, and the vast array of the different health-care professionals who depend on reliable data to make accurate and cost-effective decisions every day.
A few things that could be put into place fairly quickly (some of which are included in the proposals recently submitted to the Congress by the U.S. Department of Health and Human Services) that could work in the short term to cut costs over time and improve patient care immediately and in the future include: encouraging people to use personal health records and then sharing the health professional-specific data with caregivers; widespread adoption of electronic health records in all locations where health care is delivered, from intensive care units to home health care, from schools to work places; and, above all, insisting that all of these people and systems communicate with one another so as to maximize efficiency while protecting patient privacy.
There is much within health-care reform that is and likely will remain controversial. Getting a better handle on the information that determines the safety, security and efficiency of American health-care delivery should not be controversial in the least.
Connie White Delaney, R.N., Ph.D., is the dean of the University of Minnesota School of Nursing and a fellow of the American College of Medical Informatics and the American Academy of Nursing.