With HHS Secretary Tommy Thompson's appointment of David Brailer, M.D., as our nation's first healthcare information technology czar, much national media attention is being given to the value of increased healthcare IT investment.
As president of Partners HealthCare System, an integrated academic healthcare delivery system anchored by two of Harvard's largest teaching hospitals--Massachusetts General Hospital and Brigham and Women's Hospital, both of which have used information systems for years--I would like to comment on these issues.
While it is true that systems that improve the quality of patient care do not directly pay for themselves in the form of increased revenue to caregivers, there is no question that they reduce the cost of healthcare overall. The answer is not to forgo these systems, but instead to realign incentives so sufficient fiscal benefits accrue to the caregivers making the investment.
The argument from some quarters--that today's technologies will be outdated tomorrow--is also a nonstarter. Most technologies, clinical and nonclinical, have a reasonably long shelf life. Further, under this line of thinking, no one would ever invest in any technology because the next generation will always be new and improved.
Finally, it may be true that using these systems can sometimes--but certainly not always--be more time-consuming for physicians, and that's an important consideration. In my experience, though, physicians are eager to provide the best possible care. The real problem is, again, that existing incentives must be realigned to encourage and support the use of systems that can improve care.
There is a broader point that is critical to the incorporation of information technology into the American healthcare delivery system. To reach this goal, we need to move from a fragmented system of independent practitioners and institutions toward community systems that are sufficiently integrated, clinically and financially, to reach a threshold where they can invest in and harness the power of IT and can establish a physician culture that favors the development and use of appropriate clinical standards.
As a part of this, we need to strive for development and implementation of pay-for-performance models that could make fee-for-service arrangements meet quality and utilization objectives. Such an approach will enable these delivery systems to function within a clinically coherent framework to address current deficiencies related to safety, quality, effectiveness and efficiency.
I applaud the recent appointment of a health IT czar and trust that the work of integrating our healthcare delivery system while leveraging IT's power in this industry can really get jump-started.
James J. Mongan, M.D., is president and chief executive officer of Partners HealthCare System, Boston.