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How Health IT can Improve American Health Care

Event with Sen. Sheldon Whitehouse highlights the need for health reform and releases the new report “Navigating American Health Care.”

The WhiteHouse.gov "Briefing Room" includes a regularly updated blog and links to social networking sites. (whitehouse.gov)
The WhiteHouse.gov "Briefing Room" includes a regularly updated blog and links to social networking sites. (whitehouse.gov)

“The healthcare system in America is a total nightmare—even calling it a ‘system’ gives it too much credit,” Sen. Sheldon Whitehouse (D-RI) said opening his keynote address.

Sen. Sheldon spoke on the fractured state of the U.S. healthcare system and strategies for improvement with that frank diagnosis, providing the context for an event at the Center for American Progress which highlighted the release of CAP’s new report, “Navigating American Health Care.” The report, by Karen Davenport, Director of Health Policy at the Center for American Progress, is CAP’s response to the growing crisis in healthcare quality, and the latest component of CAP’s overall plan for reforming the American health care system, A Plan for a Healthy America. This latest report focuses on how information technology can improve health care delivery processes, quality and outcomes.

The problems are clear: a complex, fractured system of individual and institutional providers, limited ability to share clinical information, and suboptimal care processes has lead to administrative inefficiency and reduced value for our nation’s health care spending. As the report notes, the United States spends more per capita on health care than any other nation on the planet, yet experiences poorer health outcomes, higher levels of preventable illness and disability, and overall lower health status compared to other wealthy nations. Health IT, one of the fundamental building blocks of a reformed health care system, offers the potential to improve health care delivery and patient safety, while creating the information base necessary to identify and implement best practices in health care.

CAP offers short- and long-term strategies for increasing the use of health IT. The report’s immediate recommendations for overcoming existing barriers to health IT implementation and taking initial steps to realizing its improvement potential include establishing health IT interoperability standards and privacy protections for personal electronic health records, providing health IT funding for safety-net providers, and making new investments in data capacity and comparative effectiveness research.

Davenport noted that health IT will facilitate the rapid growth and development of clinical-effectiveness research—one of the most promising avenues for providing patients, providers, and payers with meaningful information on which services, medications, and de­vices are most likely to result in improve­ment or cure. This information will allow for better, more informed treatment decisions by doctors and patients.

To incubate and accelerate long-term efforts to improve health care quality, CAP also advocates launching process and quality improvement demonstration programs for diabetes, stroke, and heart disease across federal health coverage programs. These demonstrations would integrate health IT as a key tool in health care improvement, as specific applications can improve quality and safety, and as the data collection infrastructure for quality reporting. The long-term intention of this demonstration effort is to reform how Federal health programs pay for high-quality care.

Senator Whitehouse, the founder of the Rhode Island Quality Institute, a collaborative effort between health care providers, insurers, and government that has pioneered efforts to expand the use of electronic prescriptions, is well versed in health IT’s potential for improving health outcomes. Echoing the main points of CAP’s report, he said that a lack of recognized “best practice” standards, an information technology lag, and a payment system filled with perverse provider incentives are core problems that need to be addressed. Noting that health care quality initiatives may provide the “R&D” for systemic health care reform, he particularly emphasized the need to create a new business model for quality improvement, including a payment system that rewards providers who provide higher-quality health care. He also argued that the US has been slow to adapt information technology in the health care sector because no agency or organization has central responsibility for building-out our health IT infrastructure, and resolving the technical issues related to greater use of health IT.

The senator was followed by a panel that included Davenport; Gerald Shea, Assistant to the President of the AFL-CIO; and Mark Carroll, MD, Telehealth Program director for the Indian Health Service.

Bringing a unique perspective to the table, Carroll presented the advanced technology and communication infrastructure the Indian Health Service has implemented to manage the health and health care of its client population. Through a new chronic care management system, iCare, IHS is able to manage individual patients’ health care needs while tracking, and ultimately improving, its ability to manage the health status of 1.9 million Native Americans and Alaska Natives. ICare supports establishing and monitoring goals for individual patients, interactive care planning, and routine public/population based health reporting as an integral system component.

As a leading executive to the largest federation of unions in the nation, Shea noted that the AFL-CIO negotiates insurance benefits and premiums for over 40 million workers nationwide. Quality of care has become a primary concern for union members and union negotiators—and Shea therefore emphasized the need for national quality measurement standards. Shea also noted that health IT, which forms the information infrastructure for quality reporting, and quality improvement itself, represents a bipartisan opportunity to make immediate progress on improving our health care system and setting the stage for health care reform.

Read the report:

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