Happy New Year, HealthNex readers. One of my resolutions is to pump up the volume on posts for this important topic. To that end, I want to call out to my IBM healthcare colleagues to step up and help feed the beast. Towit, here is a recent article from IBM's w3 intranet, on some of our efforts to catalyze change in healthcare.
Step into an emergency room in any major U.S. city and you will get a glimpse of the bureaucracy that cripples the nation's healthcare system. Or visit a favela in Sao Paulo and you will see that access to basic healthcare services is virtually nonexistent.
Today’s strained, often inequitable healthcare systems threaten economic and social instability in some parts of the world. Governments and non-governmental organizations must confront the deficiencies in their healthcare systems surrounding primary care, disease management and medication costs.
IBM is a strong proponent of an integrated, public-private approach that will render healthcare more accessible and affordable while also making the key stakeholder — the patient — the focus of care. Already we are partnering with local, regional, national and federal governments to make patient-centric healthcare a reality.
Putting a broken system back together again
In the United States, IBM has been working with President Bush and the U.S. Congress to address a fragmented healthcare system. In early 2006, IBM's Dr. Jane Barlow and Ivo Nelson testified before two separate U.S. congressional subcommittees, calling for a new paradigm that makes healthy outcomes the essential part of any healthcare system.
Ned McCulloch, IBM Governmental Affairs, observes that a more functional system would give patients and doctors a complete picture of the patient's health, including medical history, lab results, hospitalizations and medication.
"The will to create this patient-centric healthcare model is fundamental," says McCulloch, "but equally important is creating interoperable IT infrastructures that connect hospitals, agencies, research institutions — just about everyone who has a hand in shaping healthcare for individuals and populations."
In lobbying for a transformation of the current U.S. healthcare system, McCulloch and IBM colleagues, such as Dr. Martin Sepulveda, vice president, Global Well-being Services & Health Benefits, begin their advocacy work by focusing on a problem that inhibits the development of a truly patient-centered model. One of IBM's recommendations is to create a reimbursement structure that primarily rewards providers for increasing patient health — instead of rewarding providers for seeing as many patients as possible, as is the case today.
"In the current Medicare statute, for example," says McCulloch, "the Centers for Medicaid and Medicare Services do not reward healthcare providers for sharing information that, say, would reduce medication errors. At IBM we're working to craft a solution that would reimburse providers for doing that."
Does anyone have any clout?
No one understands the shortcomings of the current U.S. healthcare system better than employers, who have collected metrics on quality from their insurers and providers. Working with IBM and other large employers, government agencies are now looking at the role that IT can play in reducing medical errors, integrating lab results, x-rays and medical history and encouraging patients themselves to take more responsibility for their wellness.
The impact that employers in Germany and France, for example, can have on reimbursement structures can be even more profound, especially as those governments pay for a significant portion of their citizens' healthcare. In China and India, where the individual shoulders more of the financial burden for healthcare than in the United States or Europe, the role that employers can play in reforming reimbursement structures becomes even more critical.
Johan Hjertqvist, president of Stockholm and Brussels-based Health Consumer Powerhouse, observed recently in The Wall Street Journal that two out of three European Union countries delay the introduction of new medicines into the reimbursement system. An integrated healthcare system could expedite access to these medicines — and ultimately facilitate more healthy outcomes.
Change or stay the same?
Governments are potentially the most influential agents of change and paradoxically the most stubborn in their commitment to healthcare systems they have created or inherited. Will they overcome their reluctance to legislate the changes necessary to implement an interoperable, standards-based healthcare system?
IBM is working with governments around the globe to help ask the questions — and shape the answers.
Healthcare legislation in the U.S. Congress
S.1418: Wired for Health Care Quality Act
Currently in conference with the U.S. House of Representatives,
S.1418 would create grant authority for health information technology
projects. It would require that federal agencies accept medical reports
submitted via standardized electronic systems. This legislation
received Senate approval on November 18, 2005.
The bill would provide for the implementation of an electronic health records system under the Federal Employees Health Benefits Program. This legislation received approval from the U.S. House of Representatives on September 14, 2006.
A very thought provoking article. Thanks Jack.
One thing I'd like to add is that if you watch how a retail assistant, waiter or bar tender interacts with their terminal, it is very quick and rapid fire. Tokens often allow near instantaneous log on. Then they punch some buttons and walk away. How long do you think it took to train new joiners? Not long- they probably picked it up on the job.
Now look at how clinicians access health care IT. Ouch.
Add that to the list.
Posted by: ClickRich | January 04, 2007 at 05:08 PM
As a parent of a child with a disability, I am desparately in need of "patient centric healthcare" and I would love to add the local school district to the list of constituents who need information and can contribute to the information pool about my child's medical issues. Under the Individual with Disabilities Education Act (IDEA) students are classified by their disability. We receive services through the school district (eg speech, OT) which ideally should be coordinated with private psychologists, psychiatrists, pediatricians, speech therapists, etc. We need to keep the school staff informed about experimental medication trials but they have no training on what to observe and are concerned about legal implications if they give any feedback. Furthermore, they have no way to communicate with the student's medical professionals. They all say they can't use email because it is not HIPPA compliant -so even simple communication tools are off limits. The consumers of all these uncoordinated services need to push for patient centric healthcare.
Posted by: M Madfis | January 08, 2007 at 12:02 PM