At New York-Presbyterian Hospital, integrating a new medical information technology system adds 30% to its cost because it must be customized. Imagine how much it would cost to customize an adapter for every lamp, television or toaster you buy, just so you can plug it in. That is what hospitals face without industrywide standards. The millions of dollars we spend each year integrating information technology would be better spent caring for patients.
The advancement of care is what we all seek. Already New York-Presbyterian, known for innovation, is working with and creating the next generation of technology.
To ensure safety, the hospital purchased a prototype to allow remote monitoring of intensive-care patients. Called eICU, the product allows specialists in intensive care, who like many medical positions are in short supply, to view patient data at a distance and make recommendations to staff on site.
Our research also is helping to develop a patient health monitor to collect patient data and use artificial intelligence to analyze it. This can be a vital tool for diagnosis and improving care.
But all our technology research and such work at many other hospitals have been made much more difficult by the lack of standards to allow the smooth flow of data within a hospital and among facilities.
Hospitals need a national investment in IT and standards to facilitate information sharing within a hospital and between hospitals. Such an investment would reduce errors that in turn will improve patient care, increase hospital efficiency and help hold down malpractice insurance costs.
The House of Representatives has approved the Patient Safety and Quality Improvement Act to help make national standards a reality. The U.S. Senate now must pass the measure.
The House bill would help create voluntary standards for IT. This would be invaluable to the nation's hospitals and help push companies to allow communications among the various technologies.
It has the full support of HHS Secretary Tommy Thompson, who recently instituted information standards in government hospitals. Thompson has said better integration of technology is found in supermarkets than in hospitals.
It is too true. Few of the different systems used in laboratory, pharmacy and radiology work-the fundamental tools of medicine-are integrated. Despite technological advancements in each of these areas, patient care still most often requires shuffling between reports.
Why is an integrated system so important? Because better integration allows systems to communicate and prevent errors, protecting patient health. Without it, a prescription may be misspelled. An allergy, noted on a chart, may be missed. Drugs interact negatively because up-to-the-minute patient information isn't available. Data on medication errors show that 2.8% of all hospitalized patients experience a preventable adverse drug event. In addition to the human suffering, errors cost the U.S. healthcare system an estimated $2 billion per year.
These are errors about processing data, precisely what computer systems are meant to do best. But the lack of IT standards hampers our nation's healthcare facilities and denies the best possible patient information to our medical workers.
To use one example, a computerized patient record would be a vital tool for doctors and nurses, who could see on a single screen all of a patient's relevant information for proper diagnosis and care. Such a record, if able to be viewed by any hospital anywhere in the country, would be a tremendous advance.
But such a record exists now in less than 5% of hospitals and few of those hospitals can share records. To accomplish this throughout the country requires standards set at a federal level and financial help to acquire IT.
The House bill would do much to advance this work. It would empower the HHS secretary to periodically review and upgrade the standards in consultation with expert advisers. Grants would be available to hospitals, which lack the resources for large technology improvements to help advance the technology and compatibility. Thompson also has recommended that Congress create a capital fund to help hospitals cover the cost of information technology.
In addition to standards, the House bill also would require that information about medical errors and near errors be stored in a central registry. The hope is that through technology error patterns can be traced which will help prevent many future medical mistakes.
Once standards are in place, information between hospitals can be shared to serve as an early warning system for smallpox, plague or other possible bioterror agents.
Most important, integrated medical systems would provide the consistency of care we expect throughout our hospitals. Our doctors, nurses and medical staffs would have the information and checks they need to provide patients the best possible care.
Herbert Pardes is president and chief executive officer of New York-Presbyterian Hospital.
Editors note: Last week, Linda Kloss, executive vice president and chief executive officer of the American Health Information Management Association, wrote about the need for a national electronic health information infrastructure (May 12, p. 21). This week, a top hospital administrator discusses how a lack of such a system affects his organization and what needs to be done in Washington to help solve the problem.