The Role of Health IT in Health Care Reform

Health Information Technology’s Critical Role in Reforming Health Care

As Americans try to decide who their next President will be, high on their list of priorities is who will offer the best fix to a health care system that is fragmented, increasingly expensive and unaffordable, and which provides care of inconsistent quality and, at times, questionable value.  Combined with 47 million uninsured, the war in Iraq, dramatic erosion in the housing and financial markets, and out of control energy prices, our nation finds itself in the eye of a foreboding economic perfect storm.

The good news is, our health care system has enormous potential to be part of the solution, with tens to hundreds of billions in untapped savings. With health care representing a stunning 16% of the Gross National Product, the time to bring order and sanity to the health care system is long overdue:  decisive actions must be taken now to help keep health care affordable and the U.S. economy solvent.

Both presidential candidates have an extensive plan for reforming health care, with the common goals of bringing down costs, expanding access and coverage, and improving care quality and value.  Central to all their solutions is the widespread adoption of health information technology (HIT), which carries with it the ability to improve quality and reduce waste, increase efficiency and productivity, reduce medical and medication errors, improve care coordination, engender greater patient involvement in ensuring good care outcomes, and help researchers find out what treatments work best clinically.

There are strong indications of just how powerful a catalyst and tool HIT could be in remedying many of the U.S. health care system’s ills.  According to two Rand studies[1] [2], widespread HIT adoption could generate savings of $162 billion or more annually.  Nearly half of the estimated savings—over $77 billion—would derive from improved efficiencies and reductions in duplication, preventable medical and medication errors, and streamlined administration.  Even greater potential savings could be expected from lower death rates, fewer complications, and fewer employee sick days from chronic diseases. Annual maintenance costs for such a nationwide HIT system would be about $10 billion per year, a very small fraction of the savings it would generate.

Also documenting HIT's strong potential for cutting down the nation's health care bill is a December 2007 report from the Commonwealth Fund[3] . In addition to efficiency, quality, and patient safety savings, the report projects $368 billion could be saved over 10 years—through investment in and sharing of medical effectiveness and outcomes research, made possible through widespread electronic access to patient care information. 

The eHealth Initiative (eHI) is heavily involved in developing strategies to improve the quality, safety and efficiency of health care through information and information technology.  Through the Partnership for Connecting Communities program, eHI is raising national awareness of the value of and accelerating the use of electronic health information to address current U.S. health care challenges, including those related to drug safety, chronic care management, medication management and fast-forwarding research on both outcomes and effectiveness.

Our Presidential candidates, members of Congress, and leaders from every sector of health care all agree that health care reform is a top priority on the domestic agenda, and that health IT can be a vital tool in driving the changes needed. Yet much more progress is needed with only four percent of physicians having a fully functional electronic health record (EHR) and another 13% have a basic EHR. 

What will it take to drive our shared vision of a nationwide, connected, electronic health care system that supports care delivery, improves population health, and enables consumers to effectively navigate our fragmented health care system, while effectively managing privacy and confidentiality?

Share your ideas and insights by submitting a policy paper that "takes the pulse" of where we are on health IT--offering a review of the progress we've made, how it compares to where we thought we would be, and the critical steps that need to be taken in 2009 and beyond to get to our goal. We'll compile the papers, share them in an interactive publicly accessible web site to enable national, state and local leaders to have a dialogue with you and others on your ideas; publish them in a policy compendium to be shared broadly with policy-makers; and invite the authors of those papers to present their insights at eHealth Initiative's Fifth Annual Conference and Awards Dinner to be held on December 3-5, 2008 at the Ronald Reagan Building and International Trade Center in Washington, D.C.

As noted in eHI's recently released eHealth Initiative Blueprint: From Consensus to Common Action, we believe that health IT is not an end unto itself, but a means to an end--which is a higher quality, safer, more value-driven, and accessible health care system. And therefore we are particularly interested in hearing about how health IT has enabled progress on a number of fronts which are outlined below:

• Improvements in Quality and Efficiency
• Engaging Consumers and Patients
• Care Coordination and Chronic Care Management
• Increasing Access and Addressing Disparities
• Getting to Better Evidence on Outcomes and Effectiveness

We'll also tackle traditional policy issues such as those related to financing, standards for interoperability and privacy and confidentiality.

Billions of dollars are spent each year to measure and improve care, conduct research, monitor the effectiveness of treatments and safety of medications, track public health threats, engage consumers in their own health care, and manage chronic disease. While all of these processes rely greatly on health information, very few of them are tapping into the enormous amount of electronic clinical health information that currently resides in physician offices, hospitals, laboratories, pharmacies and other health care-related organizations.

The eHealth Initiative's overriding goal is to help transform the U.S. health care system by raising national awareness of the value of and accelerating the use of electronic health information to support these health care needs--and the key focus areas of health care reform--improving quality, reducing costs, and increasing access.

By sharing your ideas through this process, you can help advance this goal by imparting your special knowledge and key insights based on your own experiences--whether in the field, in the policy arena, or in the academic environment. It will take all of us to move the ball forward.

If you would like to participate and submit a paper, you must do so by the August 31 deadline to be included in the compendium and be considered for a presentation in December at eHI's Fifth Annual Conference. We also ask that you complete an intent form providing your name, contact information, and topic area no later than July 31. Any questions should be directed to Jennifer Covich at Jennifer.covich@ehealthinitiative.org

In summary, as noted in eHI’s Blueprint, while HIT is not an end to itself, it is a means to a much bigger end—a higher quality, safer, more value-driven health care system in which every American can put their faith.  Bringing widespread usage of HIT to the health care marketplace, through the building of strong public and private stakeholder consensus, collaboration, and support, is what eHI is all about. I hope you will join us in this endeavor. We have made some progress, but there is still much, much more work to do!

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