Healthcare Transformation in the Information Age
The need to transform care
To understand this, one need only look at the state and trajectory of U.S. healthcare costs and quality. We have the world’s highest healthcare costs per capita, which are rising at an unsustainable rate. The United States lags other industrialized nations in important measures of quality, with 50 million people uninsured, limited access to care, high administrative costs, defensive medicine, aging populations, disconnected information systems and a payment system that pays more for quantity than quality. In particular, perverse financial incentives to physicians to provide more care rather than better care inhibit the use of electronic health record systems (EHRs) to improve quality and value.
Foresight and inspired action
Several mid-Michigan healthcare enterprise leaders were both humbled and inspired to do better by the Institute of Medicine, which described the U.S. healthcare system as broken and in need of redesign, with EHRs playing an essential role. The IOM described robust EHR systems as the “most essential of all elements of modern healthcare.”
Michigan State University President Lou Anna Simon responded to that challenge in 2002, ensuring that the MSU HealthTeam implemented an EHR system to improve healthcare quality, efficiency and information flow within its large, multidisciplinary group practice. The HealthTeam was recently recognized as the top practice in the state of Michigan for use of evidence-based best practices, an achievement that an EHR system helped make possible.
President Simon and visionary leaders from Sparrow Health System, the Michigan Department of Community Health, the Capital Area Health Alliance and Lansing Community College have since taken an important next step to make sure that secure electronic information flow between institutions where patients receive care became a reality. The result is the Great Lakes Health Information Exchange. GLHIE provides a mechanism by which important health information stored in area physician offices, hospitals and testing facilities can be accessed by authorized health professionals throughout the region via a secure Web connection or by direct delivery into their EHRs. Being able to access such information made an important difference in the outcome of one of my patients in the first weeks after it became available.
A window of opportunity
For the next few years, health professionals will be able to qualify for financial incentives to transform their practices with EHRs. Under the HITECH Act, the Centers for Medicare and Medicaid Services is now providing incentive payments to hospitals and eligible professionals for EHR “meaningful use” to 1) improve quality, safety, efficiency and reduce health disparities; 2) engage patients and families; 3) improve care coordination; 4) improve population and public health; and 5) ensure adequate privacy and security protections for personal health information. The first stage of the program is under way and emphasizes data capture and sharing. The second stage (2013) will encourage use of improved clinical processes, while the third phase (2015) will provide incentive payments for better patient outcomes.
What this means to business leaders
These dramatic changes mean that business leaders soon will be able to expect area healthcare institutions and professionals who care for your employees and families to use EHRs and HIT to support best practices, share information and provide you with data on quality and value. This is no different than you expect of your suppliers or are expected to show to your customers. While this will be a big change for many of us, our patients should settle for nothing less.
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Michael Zaroukian, MD, PhD, FACP, FHIMSS is professor of medicine and chief medical information officer at Michigan State University. He is also medical director of clinical informatics and care transformation at Sparrow Health System. He recently received the 2010 Physician IT Leadership award from the Health Information Management and Systems Society.