A recent Wall Street Journal Online/Harris Interactive survey indicated that a majority of Americans believe electronic medical records can reduce healthcare costs while improving patient care. Yet, the number of physicians using EMRs still hovers below 20% nationally.
The juxtaposition of these figures reveals the gap between perception and reality in the healthcare technology debate. Theres a lot of talk about technology saving healthcare, but these two statistics show that its not that simple, especially when it involves managing chronic diseases.
Treating the effects of chronic disease eats up a significant portion of the healthcare dollar. According to the Milken Institute, the cost of treatment and lost productivity caused by chronic illnesses in the U.S. is more than $1.3 trillion per year and, if left unchanged, costs could reach $6 trillion by 2050.
As a practicing primary-care physician in Indianapolis for 20 years, I know firsthand how challenging it is to manage acute problems and chronic diseases. I also know how valuable EMRs can be in supporting patients with complicated disease histories.
While I was fortunate to train and practice in a setting where these systems have been in use for decades, that is not the case in most of the country. Widespread adoption of EMRs is, and will continue to be, elusive.
There is, however, a way to overcome this barrier while managing patients more effectively. Heres one possible solution: For nearly 15 years, I also practiced in a local emergency department. There, I was able to use a system that is available in 36 hospitals in central Indiana that securely aggregates and accurately delivers laboratory results, reports, and medication and treatment histories across all providers, regardless of hospital system or location. Weve seen this system save approximately $10 per emergency room visit.
This system is replicable and expandable. In fact, were extending use of the system to outpatient centers and ambulatory practices, providing an opportunity to add new programs and uses on top of an already valuable system.
The concept for one such program is simple: Physicians receive reports containing actionable information about their patients based on clinical data from this system and claims data from participating health insurers. These reports identify for physicians their patients who have chronic diseases and how well those patients are doing. It also provides alerts and reminders of when patients are due for certain screenings.
The information is presented in an easy-to-read format that enables the physician to view which patients are getting these tests completed and the results. This is all possible even for physicians that dont have an EMR, allowing us to reach even the small practices.
The program also provides the physician with a summary of various aspects of care across all of their patients, along with comparisons to their peers in the community. It also acts as a clearinghouse for best practices, helping physicians learn from each other.
Access to actionable patient information and real-world care comparisons are incredible tools to improving overall patient health.
The other key component of the program is how the physicians are reimbursed. Almost all physicians are still paid by the quantity of patients they see in one day, not by the quality of care. The most important componentthe patients healthis almost an afterthought.
This program is being used with primary-care physicians in the Indianapolis area, but its expanding out to specialty groups and other markets in Indiana. Because of the participation of national insurers and a technology infrastructure that can be replicated, this program could be used in other areas of the country.
The collaboration of the entire healthcare continuum on the design and implementation of this program is what makes me truly believe that this will make a significant difference in healthcare.
It has been said that an ounce of prevention is worth a pound of cure. In this day and age, we are still practicing reactive medicine. Its time we changed to proactive medicine.