6th Annual World Healthcare Congress, Day Three, Part 2
by jingemi
The second discussion focused on Healthcare IT Infrastructure (and I hope that I can capture everything that was discussed). The host of the discussion Dr. William Winkenwerder expressed the role of Health IT infrastructure well. He called local Health IT the “muscles” of the system and the infrastructure as the “nervous system.” Both require care and nourishment through a “circulatory system.” This was an excellent analogy.
The first panelist was the deputy director of the Office of the National Coordinator. She expressed that the stimulus infusion of resources would lead to a tipping point in Health IT implementation. She pointed out an interesting point. The $18 billion dollar allocation to CMS is actually a net cost; the actual outlay is $30 billion. She said that the necessary workforce does not exist for Health IT does not exist but the stimulus includes partnership funding with academia to close this gap. There was great money to the states to create Public-Private Partnerships that map to the federal plan. She mentioned the National Research Center and its extension centers. And she talked about meaningful use. She said that there will be much discussion to include a public meeting Apr 28-29. She said that any meaningful use must be outcomes-related. When asked about the role of government, she alluded to the Economic Advisory Panel, which solicited opinions from stakeholders and she did not rule out mandates.
George Halvorsen of Kaiser talked about health outcomes and Health IT. He said that there were ½ trillion dollars in avoidable health events. Health IT allows for the collection of the necessary data to mitigate these costs.. He mentioned that the medical community gets the treatment of asthma right only about 46% of the time. Health IT could improve this outcome. He said the one requirement for Health IT is that it must be “plug and play.” When asked about the role of government, he said that government should facilitate the use of Health IT by clearing away obstacles. When asked about security, he said that the electricity grid must be protected as well as the Health IT network. At this point, it is difficult to criminalize Health IT penetration because we do not know how the information would be misused.
Dave Merrit of the Center for Health Transformation mentioned how the previous administration did make great progress for Health IT by helping set up the governance standards. He said that there are three phases in Health IT implementation. First, EMRs must be deployed. Then, the connective infrastructure must be created. Then, interoperability must be established. His concern was that paperless siloes might replace paper siloes. He said if those siloes are broken then Health IT could be used to collect and analyze information and provide those findings to the right stakeholders. Best practices could be established and policy could be based on those best practices. The end result is evidence-based medicine. He said that possibly $1 trillion of waste possibly could be eliminated. He mentioned Intermountain as a success story. He also discussed administrative waste: 90% of medicare claims is paper-based; 70% of claims remittance is paper-based; and 60% of eligibility requests are paper-based. He said that Health IT could go beyond the clinical and improve the administrative side of healthcare. For Mr. Merritt, he said the role of government is to assist with the infrastructure. He equated the NHIN with the Eisenhower highway system.
David Cerano of Microsoft said that Health IT’s biggest competition is not among vendors but against paper records. He also differentiated between the patient (person receiving care) and the consumer (the person overseeing the transaction of healthcare delivery such as a caregiver). For Microsoft, meaningful use means that the consumer is included in the interchange and that data is separated from applications. Mr. Cerano also mentioned that the presentation of data in a meaningful way is essential. He concluded with Microsoft’s goals being to liberate data, empower people and connect care.
Overall, this was an extraordinary discussion.
