Health IT week: Technology & innovation can check rising health costs

Three major advances have been in the areas of electronic health records to
document and provide priceless information for patient care and coordination,
tele-medicine, and in-home monitoring – all of which are becoming more
mainstream tools through private investment and cultural change.
 
Patient record keeping has traditionally been a labor-intensive activity.
 Typically, the task of filling out piles of forms and often duplicate,
missing or redundant information has fallen on the patient, offices scribes or
managers.  Doctors dictate observations, orders or referrals that are
transferred to a series of forms and charts which are placed into a folder that
joins a wall of other color-coded charts for other patients.  
 
Along the way the physician has scribbled a prescription which the patient
carries to their pharmacist who reads it, enters it into a computer system,
fills it and hands a plastic orange bottle back to the patient.
 
To help combat the ever-increasing “back-office” costs of running a practice,
more and more doctors have joined together to shoulder the burden collectively.
 It is not at all unusual to see more clerical staff than medical staff in
even a small joint medical practice.
 
The major issue in automating patient records has been the inability of
different systems to “talk” to each other so the records of a patient who lives
in Minnesota can be read by the medical staff in emergency room visit while the
patient is on vacation in Florida.
 
The simple fact is these mounds of paper and countless hours of tasked labor
cost our system dearly.  According to the Lewin Group, about $200 billion
is wasted on administrative inefficiencies.  Ingenix estimates $30 billion
in annual costs of paper remittance advice, checks and claims for services.
 
With broadband enabled EHRs, records can be managed and accessed with safety,
security and speed, but more importantly, with confidence that nothing has been
lost “in translation” from one medical office to another.  This allows
medical professionals to concentrate on the needs of the patient, while
practicing high value, quality medicine enhanced by clinical decision support
through an EHR.  The payoff?   $260 billion in reduced variation
in care delivery.  
 
Improved tracking of what was delivered to whom and when will make health care
fraud, a burgeoning growth industry, less likely.  We’ve just saved
another fraction (3 to 10 percent) of the $260 billion in annual fraud losses.
 
The other significant development with the advent of broadband is the
fast-growing area of tele-medicine.   As the equipment of medicine
becomes more expensive and its deployment is more centralized, the access route
to the benefits of new technologies has been to travel to a major medical
center whether they live a few blocks or hundreds of miles away.
 
The result has been a method of health access largely defined by accidents of
geography.  The haves – largely in major urban centers or suburbs; and the
have nots — largely in rural areas.
 
With high-speed access to the Internet, patients in small communities can have
access to the most modern medical technology right from their local hospital or
even a doctor’s office. Private industry continues to develop end-to-end
solutions, which allow the major medical centers to better utilize their
capital investment in new equipment, while allowing local doctors to deliver
better medical care to their patients.
 
When a procedure does have to be performed in major medical center, follow-up care
is improved by allowing the surgeon or specialist to see the patient from the
patient’s home medical facility, reducing or eliminating a long, sometimes
painful or dangerous trip to the medical center.  Patients may be more
likely to adhere to a treatment plan if they have a more convenient, less
painful, local option.
 
Our aging population is a major contributor to national health care costs.
 Regular patient monitoring of certain vital signs are another potential
cost saver.  The ability to track a patient’s vitals through the use of
automated, inexpensive devices linked to the Internet through broadband
connections can save more expensive physician or hospital visits, and the data
can be loaded directly into an EHR to monitor potential problems.
 
These changes will not be easy.  We would do well to develop EHRs with
significant input from medical professionals, the ultimate end user.
 Linking the system through broadband enabled technology will be key to
use as well.  Ever wait for a movie to download?  Physicians don’t
have that kind of time when treating a patient.
 
But the payoff can be substantial.  In this short article, we’ve
identified almost half a trillion in potential savings.  Quality of life
and health outcomes are not measured here, but the value to a patient can be
beyond price.  
 
Joel White is the executive director of the Health IT Now Coalition and a
member of the health care working group for Broadband for America.