Kolodner followed Bria as a guest speaker Wednesday. Kolodner said an ONCHIT-developed privacy and security framework will be released later this year. For many people, but not all, a driving force towards the proliferation of healthcare IT will be patients and personal health-record systems, Kolodner said.
For a number of years, Ive thought that the personal health record would be it, he said. Thats not something we can change and affect. Its very hard from a government level to drive that sort of thing.
Employers and voters can, however. Employers are pressed against the wall now. The cost of healthcare has really affected their global effectiveness. That may be one source of action that affects the politics in Washington. If tomorrow, the public gets it, that will drive it. Im not sure what might happen. I think we can move forward and can transform things. But transformation means a lot of things to a lot of people, but what we can talk about is that the model of care is changing. There is plenty of work to be done but it means changing how we do it. It means driving the cost down but driving the responsibility out to self-care.
It also means transforming care from a face-to-face model with a physician and a patient to a telecommunications-based model with the patients and the clinician at a distance, he said.
Kolodner predicted the adoption of electronic health-record systems will double in 2008 from the rather anemic levels of 2007, when a recently released, HHS funded survey indicated just 4% of ambulatory-care physicians use a fully functional EHR.
Are the health affairs of people being treated better because people can target a product now? Kolodner asked, rhetorically. The U.S. and Japan are the only countries that allow targeting of pharmaceuticals. Thats a social decision that Congress will have to address.
This is the marketplace speaking, Kolodner said in a follow-up interview after the session.
We need to make sure that people are fully informed and that they understand, as best we can to help them to understand, what the policies are of those companies. This is one area where Connecting for Health (a project of the Markle Foundation) was able to work with them (PHR vendors) to sign off on a set of principles that patient information wont be shared without their (patients) permission. Each patent will have to decide what their level of trust is and whether the comfort level is there for them to put their patient information in.
As it is, when people do searches, there is a profiling that naturally occurs when you do searches and its important that people understand that as well, Kolodner said. It is something that people will have to decide themselves.
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