Editor’s Note: This post continues a series on health information technology (IT). Yesterday Mark Leavitt rated health IT’s progress. Next up, a post by Esther Dyson. This blog series appears in tandem with new papers on the Health Affairs Web site [2-week free access], including a lead article on why we need to expand beyond narrowly focused standard setting to unlock the potential of health IT by the Markle Foundation’s Carol Diamond and New York University’s Clay Shirky; a Perspective by Robert Kolodner, the national coordinator for health IT, and coauthors; and a Perspective by David Kibbe of the American Academy of Family Physicians and Curtis McLaughlin of the University of North Carolina.
Achieving comprehensive national uptake of health information technology (IT) is a monumental issue for the United States, in terms of improving patient safety, lowering taxpayer costs, and making health care portable in our increasingly portable society. By incorporating advanced IT into our health care delivery system, we will be able to transform our current system into one that better meets patients’ needs consistently through timely, affordable, transparent, interoperable processes that assure instant access to complete medical information — anytime, anywhere — that is transmitted seamlessly and securely from provider to provider.
This future system features e-prescribing technology, thus requiring fewer copayments; it reduces medical errors, lowers inefficiencies, and eliminates duplicative testing; and it accelerates the information transfer that is needed to effectively diagnose, define therapeutic interventions, and outline discharge planning and disease management at home. This vision of our future system is real, and it is becoming a reality at this very moment for patients who are participating in the use of electronic medical records (EMRs), electronic health records (EHRs), and personal health records (PHRs).
As the founder, president, and chief executive officer of the nonprofit Patient Advocate Foundation (PAF) and the National Patient Advocate Foundation (NPAF), I have worked with countless consumers struggling with access to health care challenges who will immensely benefit from our health care system’s increasingly putting these important technological measures in place. These are the patients — whom, unfortunately, we all know or can relate to — who are dealing with the diagnosis of illness that threatens their lives and brings despair to the margins of their daily living. These are the patients we are fighting for each day.
The U.S. Department of Health and Human Services estimates that our health spending could be lowered by as much as 30 percent annually with the adoption of health IT. Our society is all too aware of rising health care spending, astronomical out-of-pocket costs for care, and growing numbers of people — insured and uninsured alike — who are unable to access their critically needed health care services due to cost issues. With an interoperable health IT system in place to share information more readily, reduce unnecessary testing, and lower copays, the cost of care for these patients will be lower — and they will therefore experience improved health care outcomes as they are able to reduce financial barriers to care and access treatment more quickly.
While NPAF is a policy organization seeking to improve access to care through state and federal regulatory and policy initiatives, PAF is a direct patient-services organization that resolves access, preauthorization, coding, and billing errors and provides assistance with expedited approvals to private and public health care programs. Speaking as the voice for the millions of patients we have assisted in securing access to care, I cannot overstate the positive system transformations to be achieved by utilizing health IT. And as a cancer survivor myself, I place great importance on advancing health IT.
The positions outlined in the Health Affairs article by Diamond and Shirky, and accompanying Perspectives from Kolodner and colleagues and from Kibbe and McLaughlin, showcase an extremely relevant and thought-provoking debate as our nation moves toward this interoperable electronic system. We have come incredibly far in just the past few years in health IT development and adoption — looking to the successes in local regional health information organizations (RHIOs), the development of community-level public-private partnerships, and a recent Medicare demonstration in selected communities providing financial incentives to primary care physician practices using certified EHRs to improve quality, among others — and we should be proud of this progress.
NPAF is supporting the need to educate physicians and other stakeholders about the new federal e-prescribing program that was included in the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008. NPAF was very supportive of including e-prescribing provisions in the Medicare legislation and is interested in educating providers and encouraging their adoption of e-prescribing systems. E-prescribing truly benefits patients by reducing medical errors, improving cost-effectiveness, providing immediate access to information, and improving medication management. I am honored to be playing a role in this development by serving as a commissioner on the American Health Information Community (AHIC), a council established by the secretary of the Department of Health and Human Services to advise him on health IT issues.
While the ground we have covered to date is remarkable, we must all work together as stakeholders — physicians, providers, patient advocates, policymakers — to see a wholly effective system to fruition, speeding its use and ensuring its safety. And speaking on behalf of the nation’s patients, we must prioritize patient security measures moving forward if we are to achieve true success. We must earn and maintain consumers’ trust in order to achieve widespread health IT adoption — and without this trust, simply put, none of the benefits of health IT adoption will be realized.
To gain consumers’ support, we must create explicit and enforceable policies, in conjunction with our development of technical standards, which serve as rules of operation for using health IT. Additionally, we must assure that online medical information is safe and protected through clear privacy measures written into national legislation, with strict penalties in place for any breaches in the authorization process.
Beyond these patient security measures, PAF and NPAF encourage a number of additional initiatives that will serve to broaden the national health IT infrastructure and make it a true success. As a member of the Health IT Now! Coalition — which unites patients, practitioners, and employers to promote the rapid deployment of health IT — we support the coalition’s principles of creating a public-private process to establish health IT standards; offering federal grants, subsidies, and reimbursement to physicians and hospitals adopting health IT; providing and promoting patient education programs to encourage the use of health IT; and establishing federal and state roles to resolve health IT issues. NPAF encourages input from all relevant stakeholders in their development and execution, and we support federal legislation to promote a connected health IT system incorporating these principles.
NPAF and PAF are extremely proud of what has been accomplished in health IT development thus far, and we look forward to contributing to its accomplishments to come. As members of the health care community, we are committed to working with a cross-section of system stakeholders — technology experts, lawmakers, physicians, patient advocates, financial experts, and others — in order to achieve full buy-in and a successful adoption of this vital technology. We encourage Congress to pass health IT legislation in this term, in order to set the stage for this much-needed collaboration, and we and our fellow coalition partners will continue to strongly advocate for these vital policy measures until they are in place.