Medical informaticist William Bria summed up the mood of anticipation and excitement Saturday at the daylong Physicians IT Symposium, one of several pre-conference sessions before the official start Sunday of the 2009 Healthcare Information Management and Systems Society convention in Chicago.
We are in the middle of one of the most extraordinary years in medical informatics thats ever been, said Bria, a pulmonologist who is the chief medical information officer at the Shriners Hospitals for Children, Tampa, Fla., and president of the Association of Medical Directors of Information Systems. The work of the past 30 years of applied medical informatics has culminated in this moment.
There has never been a time where top U.S leadership has identified HIT more prominently as key to healthcare quality and safety, Bria said, adding that those same leaders expect a proposed multibillion-dollar investment in health IT will yield financial savings.
Peter Basch, medical director of ambulatory clinical systems for MedStar Health, Columbia, Md., followed to give a hat tip to former President George W. Bush. Whatever you might think of the (former) president, we have to give him credit, he did introduce the concept of HIT as something the government is interested in.
Basch said clinical leadership is needed going forward. From experience, Basch said he knows that implementing an electronic health-record system is disruptive to practice workflows, but, as painful as it is, many existing workflows are really not worth saving, are not optimal and could use disruption."
I think if we can do it in a way when were not leading our colleagues over a cliff, it may not be a bad thing, Basch said. To illustrate, Basch asked his colleagues, about 230 physicians attending the session, to put aside for a moment any consideration of reimbursements.
If you were asked to redesign healthcare delivery to maximize value while minimizing costs to the system (and of course not providing good care for free) would you have designed non-visit based care as a fee-for-service opportunity? Basch said. I hope the answer is no.
Basch pointed to the experience of physicians at the nine-physician GreenField Health clinic, Portland, Ore., that has adopted a modified form of concierge billing for its organization, taking an annual fee from patients while accepting insurance payments.
Basch said when a GreenField patient requests care, the request is evaluated for clinical necessity and the patients wishes, Basch said. After about six years of experience with the new model, clinic physicians have found that about 70% of the care they provide is via phone or secure e-mail, Basch said, while their quality measures as good as or better than most of ours.