Perspective: Seeking the cure for health care

Our national health care system is full of contradictions.

Advanced technology is available at all levels of care. Our doctors use magnetic resonance imaging, laser scalpels, smart drugs that pinpoint and destroy only cancerous cells, microscopic wireless cameras that patients swallow, and 3D ultrasound devices that assess fetal health. Surgeons can practice operations on virtual reality simulators, learning by doing but without risk to patient. Conditions that were once incurable are now mere outpatient procedures.

Yet it is precisely the ubiquity of these amazing innovations that highlights the glaring absence of more basic technology in so much of the rest of the health care system.

Your doctor, for example, may send you to a specialist with a $1.5 million CT scanner, but every time you enter each new office you are handed a clip board with pages seeking your printed name, address, insurance information and medical history.

Amazing new medicines are on the market, but whether they can co-exist in your bloodstream depends on whether each doctor was made aware of the other's prescription. And whether the pharmacist gives you Zoloft or Zocor depends too often on her ability to discern the physician's handwriting.

Our $1.8 trillion medical system depends on antiquated paper files and out-of-date customs to make it work.

Our $1.8 trillion medical system depends on antiquated paper files and out-of-date customs to make it work. And, too often, it simply doesn't provide the level of care you deserve, as evidenced by the dire estimate that preventable medical errors cause up to 98,000 deaths in the United States each year.

A key problem is that the health-care system is based on actions, not outcomes. By design, we pay for process and not performance, placing quantity over quality for purposes of reimbursements. Whether the surgeon botches the operation, fails to follow modern procedure or performs a minor miracle, she is paid the same by Medicare or insurance.

But an even greater challenge is the lack modern information infrastructure. The digital tools that have radically improved productivity and quality across our economy have barely touched health care, and it shows. While almost every sector of our economy is transforming itself through new IT-enabled processes (such as direct-to-consumer connectivity, real-time online access to critical information, and aggregation and analysis of detailed data), our health care sector remains characterized by islands of advanced technologies in a sea of paper.

We're letting down our doctors too. By keeping vital patient information out of their hands, we limit their ability to make the best medical decisions. By failing to automate prescribing and delivery systems, we subvert their intentions and confuse their instructions. By failing to collect information on quality and outcomes, we decline to provide them with the best data they could have about the results of medications and treatments, information that would help them save lives.

The good news is there is growing recognition of the problems and need for solutions. Key senators are now proposing bipartisan legislation to modernize our nation's health-care system. For all of the partisan bickering that goes on in Washington, the fact that Sens. Bill Frist, R-Tenn., and Hillary Rodham Clinton, D-N.Y., who could both be presidential candidates in 2008, have jointly introduced legislation on that matter speaks volumes about the importance of it.

Those two leaders have been joined by Sens. Chuck Grassley, Michael Enzi, Max Baucus, Edward Kennedy, Olympia Snowe, Christopher Dodd and Debbie Stabenow in proposing important changes that begin moving heath care from a quantity-based system mired in paper to a quality-based digital environment.

To their credit, lawmakers have risen above partisanship to define this issue as a priority. But there is much work remaining. Key players in the health care ecosystem need to work with Congress to identify the best sections of each of the bills introduced, developing consensus around the key measures.

In what promises to be a long, hot partisan summer, lawmakers will need to match their encouraging announcements with action.

The first test is now before us, as Congress considers whether to fully fund the federal agency spearheading government efforts. Last year Congress refused to provide any money for the Office of the National Coordinator for Health Information Technology, delaying its important work.

This year the President has requested $125 million for this critical office. We will soon learn whether Congress is serious about modernizing our health care system. These are votes that every American should be watching.

Biography
Bruce Mehlman is executive director of the Computer Systems Policy Project, an advocacy group in Washington, D.C., that represents chief executives of IT companies.

More Perspectives

Hear! Hear! Listen up people!

Hear!Hear! Listen up people! Healthcare IS a matter of life, disability or death! Too many questions from too many people! Even THEY say the paper system is outdated; frustrating for provider & patient; & usurps valuable time which could be better used. STOP complaining & support ALL efforts to improve the Healthcare System! If you haven't had a encounter w/providers and/or insurance...you will!

[lazura]

The Problem

Many articles on this problem, all with the same conclusion. The reason that healthcare is so behind in modernizing their infrastructure is the 'Doctor is God' syndrome. Most doctor's absolutely refuse to give up control of information or be measured by real statistics. Until this 'hidden' information is available to the public, healthcare will always be behind in technology. Also, I would like to see Congress start 'brow-beating' doctors to get them to move into the current century in terms of information flows.

[ebrandel]

Beware the messenger

This all sounds wonderful, but we must remember who in fact wrote this article:

"Bruce Mehlman is executive director of the Computer Systems Policy Project, an advocacy group in Washington, D.C., that represents chief executives of IT companies."

He's on the payroll of the companies that have the most to gain.

Hello??!?!?!?

Man, has THIS corporate shill got it figured out.

Sorry, insurance companies practices of inhibiting care and limiting doctors' quotas, and just plain obscene profits, are the problem. Just exactly where are your medical records going that makes improving their transfer rate so darned important?

Think about it: Just exactly where ARE your medical records going that makes improving their transfer rate so darned important?

Not the Paper, the # of Insurers

It isn't paper that's costing us money. It is the number of different insurers and plans. I worked on software for medical billing. The number of different insurance plans, the number of insurers, and then taking into account the combinations of primar/secondary insurance, etc. is enormous. There are literally thousands and thousands of combinations available, and supporting them costs lots of money and time.

Author is Lobbyist, brother of GOP chairman -- not technical expert!

This article omits a crucial detail: the author is a big-time
lobbyist. He's Ken Mehlman's brother -- the head of the
Republican Party. The siblings have engaged in politics for quite
some time. A non-partisan publication lists Bruce Mehlman as a
"Top Lobbyist" -- http://www.hillnews.com/thehill/export/
TheHill/Business/042705_topguns.html . He was personally
responsible for getting the Lenovo deal with IBM signed and
away (not that I think it was a bad deal -- just to show the kind
of power he has): http://www.talkingpointsmemo.com/archives/
004898.php .

My point: read this skeptically, as you should read most things.
Mehlman intentionally omitted his deep inside-the-Beltway
lobbyist dealings and connections, and you should know about
them.