[Med-privacy] more EMR promo

[pmarshall]

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          May 3, 2004

OP-ED CONTRIBUTOR


    Operating in a Vacuum

By NEWT GINGRICH and PATRICK KENNEDY

W ASHINGTON =14 Health care policy is a partisan minefield, with Democrat=
s=20
and Republicans differing on everything from Medicare changes to=20
malpractice reform to strategies for covering the uninsured. Yet, while=20
the two of us have been on opposite sides of most of those battles, we=20
both believe that America's health care delivery system must be=20
transformed. To begin that transformation, we should heed President=20
Bush's call last week for widespread adoption of electronic health=20
records. As the president noted, "The 21st-century health care system is =

using a 19th-century paperwork system."

The archaic information systems of our hospitals and clinics directly=20
affect the quality of care we receive. When you go to a new doctor, the=20
office most likely has little information about you, no ability to track =

how other providers are treating you, and no systematic way to keep up=20
with scientific breakthroughs that might help you.

The results are predictable. For example, approximately 20 percent of=20
medical tests are ordered a second time simply because previous results=20
can't be found. Research shows that 30 cents of every dollar spent on=20
health care does nothing to make sick people better. That's $7.4=20
trillion over the next decade for duplicate tests, preventable errors,=20
unnecessary hospitalizations and other waste.

Not only do these unnecessary costs contribute to skyrocketing insurance =

premiums, but the lack of good information makes improvements in quality =

and efficiency nearly impossible. Every year some 98,000 Americans die=20
in the hospital from preventable medical errors, like receiving the=20
wrong medication. Nearly half of patients do not get all the treatments=20
or tests that should have been administered. This is usually not the=20
fault of doctors, nurses and other health professionals =14 these problem=
s=20
persist because of systemic failures stemming from the absence of good=20
health information.

The problem is not that we need innovation: existing technology can=20
transform health care just as it has nearly every other part of society. =

If all Americans' electronic health records were connected in secure=20
computer networks that safeguarded patient privacy, health care=20
providers would have complete records for their patients, so they would=20
no longer have to re-order tests that have already been done.

In addition, most referrals and prescriptions are still written by hand; =

computerized entry would eliminate errors caused by sloppy handwriting.=20
Computer programs can warn doctors of possible adverse drug and allergy=20
interactions, and remind them of new advances in evidence-based practice =

guidelines. Patients could also have easier access to their important=20
health information, allowing them to be active participants in their own =

care.

Moreover, in a post-9/11 world, electronic health information networks=20
would allow doctors, hospitals and public health officials to rapidly=20
detect and respond to a bioterrorism attack.

Unfortunately, health care providers are famously stingy investors in=20
information technology. The primary reason is that when new technology=20
reduces the duplication, errors and unnecessary care, most of the=20
financial benefits don't go to the providers who generate the savings,=20
but to insurers and patients.

Therefore, widespread adoption of technology will depend in large part=20
on federally organized public-private partnerships. Treasury dollars=20
could help bring providers in a particular part of the country together=20
to map out plans for a regional health information network, and to=20
divide up the costs and the savings fairly between them. Medicare could=20
sweeten the pot by reimbursing providers for money spent to use=20
electronic health records connected to a regional network.

New information systems would also allow us to reinvent the way=20
providers get paid. Right now, most doctors and hospitals get paid by=20
the procedure, regardless of quality. They get paid even if they make=20
mistakes, and then paid again to fix the mistakes. And under our current =

perverse payment practices, when providers improve quality and=20
efficiency, it frequently hurts their bottom lines.

New information systems would give us nationwide data to develop=20
standardized performance measurements for providers, so anybody can get=20
an apples-to-apples comparison about how good a job a doctor or hospital =

does. This data would also allow Medicare and private plans to=20
restructure their reimbursement practices, so that the market would=20
drive competition in quality and value among hospitals and doctors, just =

as in most other fields.

Politicians like to say that the United States has the best health care=20
system in the world. Actually, what we have right now is the best=20
medical talent, technology and facilities in the world =14 but the system=
=20
that delivers our care is badly broken. Democrats and Republicans should =

agree that moving American medicine into the 21st century is not only an =

important goal, it is also literally a matter of life and death.

Newt Gingrich, a former Republican speaker of the House, is the founder=20
of the Center for Health Transformation, a for-profit organization.=20
Patrick J. Kennedy, a Democrat, is a representative from Rhode Island.


Copyright 2004=20
<http://www.nytimes.com/ref/membercenter/help/copyright.html> The New=20
York Times Company <http://www.nytco.com/>










































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