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DHC 2007: Without fuller IT adoption, health costs might drain America's wealth

Madison, Wis. - If the pace of healthcare information technology adoption doesn't pick up soon, the United States could reach an unsustainable situation regarding healthcare costs, according to John Wade, who delivered the keynote address Wednesday at Digital Healthcare Conference 2007.

Within healthcare IT, a subject that can be dominated by talk about the barriers rather than the possibilities, there is a growing fear that its benefits are either illusory or far off. Wade, vice president and chief information officer for St. Luke's Health System in Kansas City, said there is a pending danger that is not far off, a reference to predictions that healthcare costs, which now consume 15.2 percent of the nation's Gross Domestic Product, will gobble up 26 to 28 percent of GDP within 10 years.

“I think if we reach that point, we'll bankrupt this country,” said Wade said, who believes the only way to get ahead of that curve is through information technology.

Cardiac invest

The GDP estimates are provided by Healthcare Information Management Systems Society. Wade, the chairman-elect of HIMSS, offered the example of how St. Luke's made heart care more accessible through a $1.7 million investment in a centralized cardiac telemetry system.
The system, which enabled surveillance of a patient's heart rhythm in remote, rural locations 150 miles away from Kansas City, avoids the transfer of heart monitoring while the patient is physically located in a non-cardiac unit. Thanks to the centralized monitoring system, the sickest patients can come into a rural facility and receive tertiary-level care.

While initial estimates called for a payback in two to three years, the ability to reduce staff and employ higher-quality staff helped the system produce documented return on investment within 11 months, Wade said.

He told the annual gathering of healthcare technologists that examples of the cost and care benefits of health IT abound, yet adoption isn't anywhere near complete. For example, roughly 52.8 percent of American health systems have an enterprise-wide electronic medical record, and about one-third of hospitals still lack a clinical data repository.

Even though the Bush Administration has established a goal of 100 percent EMR adoption by 2014, inadequate funding hampers the federal commitment.

Wade, a native of Massachusetts, recalled President John F. Kennedy's 1961 call to put a man on the moon, a goal that was accomplished in 1969.

“Is automating health records a bigger challenge than putting a man on the moon?” he asked.

Cost control

The potential benefits of healthcare IT also were addressed at the opening session of the conference, which explored ways to control exploding technology costs.

Speakers talked about adding value for patients in conjunction with cost control. Phil Loftus, vice president of information systems and CIO at Aurora Health Care in Milwaukee, talked of the possibility of online transactions. He said Aurora is exploring ways to have patients check for open appointment times across the system and make appointments online at nearby clinics they normally wouldn't visit if that particular clinic has an opening that corresponds to their schedule.

Such a system, which would allow for extended and weekend hours, is not only more convenient for patients, it makes caregivers more accessible, and it would allow health organizations to develop capacity across their systems.

“These are some of the ways we can add value [with technology],” Loftus said.

Marty Preizler, president and CEO for Physicians Plus, said it's important to avoid confusion about who the customers are so that organizations can deploy technology that builds value for them. In the case of Physicians Plus, a Madison-based health maintenance organization, the customers are not doctors but the people who pay the premiums. The organization is trying to leverage the Internet to provide information that can help them make good health and healthcare decisions.

For every $100 of premium, Preizler said eight percent goes to administration, and a smaller piece of that is devoted to information technology. “That's where we have to make those choices that will add value,” he said.

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