HealthNex

Mr. Nelson Goes to Washington

Ivo Nelson, IBM Health Industry Leader, Business Consulting Services

Last week, I was ask to testify to Congress on "Legislative Proposals to Promote Electronic Health Records and a Smarter Health Information System."  The testimony was before the Health Subcommittee of the Energy and Commerce Committee, which has jurisdiction over the Medicaid programs, as well as key agencies such as FDA, CDC, and NIH. [Read Ivo's full testimony.]

I'm sure many of you have seen this kind of testimony before on C-SPAN and the news, but being there in person is quite different. The Representatives who attended were those who were very interested in healthcare, and included two doctors, one nurse and others who have developed a passion for transforming healthcare. 

IBM was the only corporate panelist invited, the rest being association leaders and one hospital CEO from Evanston, Illionois. By coincidence, Healthlink--the consultancy I founded in 1992 and became part of IBM in 2005--led the implementation of an electronic medical records system in that hospital.

I was the first to give a testimony and just got finished when a series of loud alarms went off, signaling that the Representative had to go and vote, as it turns out, on an appropriations measure. Although they had planned on a 30 minute break to vote, it actually took them over 90 minutes to return, at which time the other panelist gave their testimony followed by questions and answers. Not surprisingly, nost of the questions dealt  with the political hot potato of privacy.

I say not surprisingly because before testifying, I had ask Ned McCulloch, one of IBM's  key governmental programs executives in Washington, to give me a preview of what the common threads might be in questions from the Representatives.  He said, "Ivo, there are three things they'll be concerned with: Number one, privacy. Number two, privacy. And number three, privacy." 

In particular, there was a fair amount of discussion around how varying state privacy laws will interact with federal ones on this topic.  All of the panelists had insightful, if not vested responses.

Obviously there is a great deal of focus today on electronic health records and modernizing healthcare in the US.  And it is exciting to be part of this big societal shift. But it was a special honor to be able to represent IBM, the only healthcare technology innovator invited. 

While IBM's efforts in healthcare are only beginning to be more widely noticed, this chance to participate in our democratic process was more than a personal honor. It was also  a testament to IBM's growing credibility on the Hill, and the emerging importance of healthcare IT as a key frontier for American innovation. Much of the credit goes to the quality job done by Chris Caine and his team of IBM executives focused on our governmental programs. 

Lastly, as a new contributor to HealthNex, I'd welcome your comments and thoughts on the testimony IBM offered to the Energy & Commerce Committee, as well as you views on how IBM can help bring about a smarter health system for America.

IBMHealthNex

P4P: Understanding Pay-For-Performance in Medicare

Ned McCulloch, IBM Governmental Programs Executive

A recent scan down Matthew Holt's The Healthcare Blog reminded us how practical and valuable blogging can be.

With the issue of Pay-For-Performance (P4P) in Medicare becoming a major beachhead for healthcare transformation, we were looking for examples that would help people understand the significance of P4P.

Pay-For-Performance may sound a little gorpy, but it represents a fundamental shift is the way healthcare providers would get paid for services...namely, it would reward the quality of pay, not merely the quantity.

Holt's July 27 blog post points to a recent Washington Post story, Bad Practices Net Hospitals More Money, which sharply exemplifies why pay-for-performance is so sorely needed.

IBM is supporting the move toward P4P in Medicare legislation now moving through Congress because the approach is a commonsense mechanism for improving the quality of care.

"Medicare has difficulty controlling waste because of deficiencies in the way it monitors and enforces quality standards" Post article, July 24

It is also, we believe, the most economical way for America to take the first major step toward building a true electronic infrastructure that will reduce costs and increase innovation across the vast, and, unfortunately, vastly disconnected healthcare ecosystem.

In P4P,  IBM hopes to play a central, constructive role in developing the information systems that will help Medicare manage a model built around the right incentives: rewarding healthcare quality, not merely compensating providers for how many procedures or services they provide.