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.