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Health IT: The Time Is Now



April 2nd, 2008
by Ivan Seidenberg

Americans need and deserve health information technology (IT). As the chairman and CEO of Verizon Communications Inc. and the only business representative on a federal commission to develop a strategy for health care IT standards, I have spent considerable time over the past several years promoting this technological necessity.  

In addition, Verizon helped found an unprecedented, broad-based coalition of health associations, consumer groups, labor unions, patient organizations, and other businesses to urge Congress to pass a health IT bill. I’m also the chairman of the Health and Retirement Task Force of the Business Roundtable, so on Wednesday (April 2) I will join Sen. Edward Kennedy (D-MA), Sen. Mike Enzi (R-WY), and Ron Williams, chairman and CEO of Aetna, to urge Congress to pass the Wired for Health Care Quality Act, authored by Senators Kennedy and Enzi.

The Business Roundtable represents some of the largest companies in the country, which together provide health care coverage for more than 35 million Americans. As such, we have a very big stake in an affordable, accessible, high-quality health care system. It’s obvious to us that health IT must be a critical piece of such a system.

Banks use ATMs and networked computers to give us access to our financial records anytime, anywhere, and always securely and privately. Online retailers know which books we ordered last month and what color sweater we ordered for Christmas last year. In the same way, doctors and hospitals ought to be able to access our up-to-date health records when they need them. Yet our health care system is stuck in an era of paper and pen and lacks even the simplest IT foundation for electronic communications. That’s unacceptable.

In today’s paper-based health care system, your vital and private medical records are kept in filing cabinets and cardboard boxes, and your history is scattered, with a piece residing with every doctor you’ve ever seen. This means that a medical professional can’t be sure they have your complete medical history, can’t know if it’s up-to-date, and can’t find anything in it easily.

Health IT gives your doctors — and you — secure, private, and protected access to your complete medical history. It increases convenience, brings more and better health care to underserved and minority communities, improves care for chronic illness, and can virtually eliminate nearly 100,000 deaths caused by medical errors each year. And with costs spiraling out of control, health IT is a big part of the solution to the health care problem. The widespread application of health IT could produce annual efficiency savings alone of about $81 billion — nearly equal to everything we spend today treating all types of cancer.

At Verizon, health care benefits used to be just one more element in a package of benefits, but now it is a line item in our budget of $4 billion annually and growing. Over 900,000 employees, retirees, and their families depend on our company for health care. We have a commitment to support the health and well-being of our employees and their families, so we have to figure out how to maintain this responsibility as its share of our corporate budget continues to grow. The technology to do so exists today but must be implemented thoughtfully. The first thing we need to do is adopt interconnected and interoperable standards for health IT platforms so that electronic medical records can be shared seamlessly among health care providers, as required by the bipartisan Wired for Health Care Quality Act.

Finally, Americans deserve a secure system that safeguards their privacy and provides a backup, so all would not be lost in the event of a fire or flood. An electronic system also allows monitoring and auditing, so that we know every time a record is accessed.

Each day that the Wired for Health Care Quality Act languishes in Congress means more dollars wasted and more medical errors and deaths that could have been prevented. Since this bill was introduced on June 26, 2007, an estimated 75,000 lives have been lost and more than $127 billion wasted that could have been saved if health IT were broadly used. The time to pass health care IT legislation is now.

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6 Responses to “Health IT: The Time Is Now”

  1. Arvind Cavale Says:

    While agreeing with Drs. Brenner and Ozeran, I feel that large IT companies including Verizon and insurers should come clean with the physician practices that they seek to work with in this process.

    Based on 6 years of running a completely electronic office (no paper charts) and utilising almost every available tool for secure remote access to my EMR as well as making available to my patients the option of electronic communication, I feel disgusted that there has been absolutely no acknowledgement either from Medicare or private insurers of our efforts. Insurers should first demonstrate that they acknowledge and financially reward practices that currently utiliise EMRs and other IT products (to enhance patient safety and quality of care) before other physicians can adopt technology. One cannot expect someone to change their car tires while driving the car, which is what physicians will be expected to do with transfer to EMRs. While Medical Liability companies have already recognised our use of EMR by giving discount on premium, third party payers are far behind in this regard.

    I am also very disappointed at the tactics adopted by IT companies, who continue to nickle and dime physicians who have taken the leap forward to embrace IT. In fact, I had to file a complaint wth our local BBB against Verizon for continuing to charge me for a non-existent DSL connection and subsequently disconnecting our phone lines during patient hours for non-payment of a fake bill. If IT companies continue to be perceived as such, it will be difficult for physicians to partner with them in any meaningful manner.

    I wonder if Mr. Seidenberg would offer to respond.

  2. jeffbrenner Says:

    As a solo practice family physician in an under-served community I applaud your support and interest in this topic. I adopted an EHR three years ago and it has transformed my ability to continue practicing in a largely Medicaid population. I can provide higher quality/safer care, reduce my paperwork, and reduce my overhead.

    Unfortunately, however, I think it’s important to avoid over-promising what this technology can achieve within the context of our poorly designed, dysfunctional health care delivery system. A great tool like health IT still can’t fix a house that’s falling down because the building is structurally unsound and the foundation poorly built.

    Your comment is a bit of an over-promise, “It increases convenience, brings more and better health care to underserved and minority communities, improves care for chronic illness, and can virtually eliminate nearly 100,000 deaths caused by medical errors each year. And with costs spiraling out of control, health IT is a big part of the solution to the health care problem. The widespread application of health IT could produce annual efficiency savings alone of about $81 billion — nearly equal to everything we spend today treating all types of cancer.”

    Instead you should have written, “EXPANDING PRIMARY CARE increases convenience, brings more and better health care to underserved and minority communities, improves care for chronic illness, and can virtually eliminate nearly 100,000 deaths caused by poor quality health care. And with costs spiraling out of control, EXPANDING PRIMARY CARE is a big part of the solution to the health care problem. The widespread application of PRIMARY CARE could produce annual efficiency savings of 30% of our health care costs. This has been well documented by the research published in the Dartmouth Atlas. A strong primary care base empowered with well designed health IT could truly transform our nations health infrastructure and save billions in the process.”

    The evidence-base for Health IT is still limited. It’s an emerging technology that we don’t fully understand. A much bigger issues that you and other business leaders should be very focused on is our nation’s collapsing primary care infrastructure. There aren’t going to be enough family doctors, general internists, or general pediatricians to use any of the health IT. Health IT should be one part of a much larger transformational agenda that is best summed up in the movement to build a patient-centered Medical Home in a system with a stronger primary care base. See the Patient Centered Primary Care Initiative at http://www.pcpcc.net and Transformed at http://www.transformed.com

  3. L Ozeran Says:

    I have promoted Health IT for over 20 years. It has always been the time to adopt improved HIT. Whether this bill is the right way to do it is what I wish to address.

    The bill is long, but after skimming the wording, it appears to me that the best financial option it offers to providers is the 3:1 matching grant from the government. If you qualify, providers pay 25% of the cost to implement (though you are on the hook for 100% of the operational costs). During the transition, the provider also loses income from reduced productivity of professionals and staff. Other financial options discussed provide even less financial assistance. This suggests to me that the bill has laudably taken the status quo forward, but remains short of what is needed to be effective.

    It has been well documented that about 85% of the financial savings from implementing HIT accrue to the insurer. When Dr. David Brailer was our first director of ONCHIT, he made it clear that to get effective HIT implemented, we need to have financial incentives aligned. This means that Medicare stands to gain 85% of the cost savings that result from Medicare beneficiary treatment using HIT. Similarly for Anthem/Wellpoint or United Healthcare. Yet, the private insurers who benefit most pay nothing and providers who benefit least pay substantially.

    Medicare and Medicaid often pay below the cost of care. Insurers often pay based on Medicare rates and very few providers can negotiate for payment increases to counter increasing costs. On top of inadequate payment for care, it is unreasonable to force providers to shoulder an additional cost rightly borne by the insurers.

    As it stands, the bill could become another unfunded or underfunded mandate on a healthcare system already spiraling toward insolvency. The question is not whether we need HIT, the question is who should pay for it.

    At a minimum, this bill needs additional verbiage to ensure that the ongoing operational costs are covered by whoever is paying for services and that private plans will participate to increase available funding for implementation, perhaps even up to their fair share, 85% of costs.

  4. Cynthia Nustad Says:

    There is a wonderful and powerful message in this article. I would challenge us to also move more directly with our communications and ask that this Act have compliance deadlines for both service providers and vendors of technology to service providers. In the healthcare industry specifically we have had poor examples of legislation that was intended to help reduce healthcare waste (HIPAA, NPI). These two examples have allowed some improvements in administrative processes, but they are a far cry from what was proposed. The time is absolutely now to move to standards of interoperability and communication so that we can be consumers of healthcare with the ease that we navigate our banking and shopping needs.

  5. Bruce Hahn Says:

    Health IT can save American homeowners and other consumers money and lead to better healthcare outcomes. We hope that Congress will promptly pass legislation to achieve these goals while protecting privacy and the security of health records.

  6. rjohnson Says:

    The lives lost and dollars wasted are a shame. This is one of those few issues that should be non-partisan and noncontroversial. Congres must act this year to set the standards for Health IT. Consumer deserve the information necessary to make intelligent medical decisions for themselves and their loved ones. Electronic Medical Records are the key to making this happen.

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