Health Secretary Says IT Will Help Quell Inefficiency

PALO ALTO—The American health system is “saturated with inefficiency,” Health and Human Services Secretary Mike Leavitt said Monday at a gathering of Stanford medical faculty and students.

In 1960, health care costs came to about 5 percent of the GDP (gross domestic product), he said. Now it is estimated at about 15 percent. Other countries spend a much smaller proportion of their GDP on health, Leavitt said, making them more competitive in a global marketplace.

As an example of inefficiency, he described how an acquaintance with two children had to take an entire day off work to physically collect her children’s medical records from several different offices.

Information systems that exchange health information are key to bringing down costs, Leavitt said. Specifically, Leavitt said his department will push for better ways to identify adverse drug reactions, common health IT standards, and more opportunities for consumers to share and control their medical records. It also will try to shift health care’s focus away from treating disease and toward maintaining health.

After the meeting, Leavitt toured PAMF (Palo Alto Medical Foundation), widely recognized for its use of health IT. The visit showed how technology can improve care, but it also highlighted the gaps preventing IT from being more effective.

One woman said she used the foundation’s online patient portal to schedule procedures for her husband, who has Alzheimer’s disease. “It saves lots of telephone tag,” said Marianne Marx, who likes to log on late at night, when she is not working or caring for her husband.

Patients at PAMF are prompted to schedule visits for preventive care; they can also access their test results and other health information online. For $60 a year, they can ask their doctors medical questions through a secure messaging service.

Sal AbiEzzi, a physician at PAMF, says he has about 1,000 patients enrolled in the service. It’s far from a burden, he said, adding that he gets four or five e-mails a day and can answer them when he is not busy seeing patients. “I can do 10 times as much as I used to do with less time,” he said.

But patients moving between PAMF and another system with electronic medical records would have to start from scratch. Their information would need to be printed out and re-entered, said Paul Tang, chief medical information officer at PAMF. “There’s no real format to dump data into another system.”

Read more here about how IT can improve patient care.

The Bush administration has repeatedly called for electronic, interoperable medical records to be in place within the decade. Right now, only a minority of doctors uses electronic medical records, and even fewer can exchange clinical information with other entities, such as reference laboratories, doctors’ offices or hospitals.

Leavitt said the government will not mandate common standards but will encourage “organic collaboration” by bringing together important players and by being quick to adopt standards. The government pays 46 percent of the nation’s health care costs, he said. “If we adopt standards, it will move the market.”

Common standards could improve interoperability, but they also could make existing products obsolete, causing some clinicians to delay adopting technology. Leavitt said the industry can find ways to avoid obsolescence and protect past investments.

Protections against the misuse of patients’ medical data will need to be extended, he added, saying there can be no progress without privacy.

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