Sunday, September 14, 2008

HIT Must Move Ahead

Moving Health IT forward is key to solving many of the healthcare issues now facing this country. According to Senator Sheldon Whitehouse (D-RI) speaking at the Capitol Hill Steering Committee on Telehealth and Healthcare Informatics lunch briefing held on September 11, 2008, there is an urgent need to build the interoperable health information network to drive savings, produce better quality, provide more effective care, and to reduce medical errors.

However, the Senator pointed out that health IT reform presents problems to physicians. It is not only the cost for the installation of the EMR system, the costs involved maintaining the system, but in addition, doctors can risk changing the workflow in their office.

Robert Kolodner, MD, HHS, National Coordinator for Health Information Technology, explained that exchanging medical information electronically just became personal. He recounted the story of how his 93 year old mother living in an independent living community just had surgery.

The immediate problem was that forms had to be filled out many times with the same information. This could be made so much easier if there was a central repository for the data. Since his mother needs to receive care and requires care coordination, this also would be so much easier if all her providers had access to the same records and could exchange information.

However, Dr. Kolodner reports that advances have been made. Telemedicine is helping in rural areas, electronic health records are used more and more, and personal health records are emerging. Even though interoperable health information is available today in only a few communities, advances in health IT are actively appearing on the horizon.

Dr. Kolodner stressed that NHIN will be invaluable in exchanging information but NHIN is just the beginning as more and more technology will evolve over time. Dr Klodner announced that on September 23rd at the AHIC meeting, a demonstration will show how NHIN works.

Dr Kolodner continued to say that the Federal government must continue to make information better and available to all so that providers and patients will be able to make the right choices and be able to use the information in a secure environment any time, and anywhere.

The eHealth Initiative’s survey “Fifth Annual Survey of Health Information Exchanges at the State and Local Levels” just published September 2008 shows some very positive developments.

Janet Marchibroda, CEO, eHealth Initiative summarized some of the findings:

  • Operational health information exchange initiatives have increased considerably including18 new health information exchange initiatives
  • A majority (69%) of the fully operational exchange efforts report reductions in healthcare costs and report a positive financial return on their investment for their participating stakeholders
  • About half of the fully operational exchange efforts report positive impacts on healthcare delivery
  • State and local health information exchange efforts continue to view the engagement of multiple stakeholders as a priority
  • The most important drivers for operational initiatives are related to quality, patient safety, rising healthcare costs, and inefficiencies experienced by providers
  • The most significant challenge for all efforts continues to be the development of a sustainable business model

Rachel Block, Executive Director, New York eHealth Collaborative, and President, eHealth Initiative Foundation, led a panel discussing consumer, physician, and health plan relevant issues. The panelists included Paul Cotton, Senior Legislative Representative AARP, William Handrich, MD, Informatics Officer, CIGNA Healthcare, William Hazel, MD, Practicing Physician, Member, Board of Trustees, AMA, and Liesa Jenkins, Executive Director, CareSpark.

The group consensus was that while developments are encouraging, more consumer involvement and Federal support is much needed and we must be open to approaching the problem in several ways—one approach does not fit all.

Continuing Honorary Steering Committee Co-Chairs are Senators Kent Conrad (D-ND), Mike Crapo (R-ID), Sheldon Whitehouse (D-RI), John Thune, R-SD), and Representatives Eric Cantor (R- VA), Rick Boucher (D-VA), Bart Gordon (D-TN), Allyson Y. Schwartz (D-PA), David Wu (D-OR), and Phil English (R-PA). The Steering Committee coordinates many activities with the House 21st Century Health Care Caucus, co-chaired by Representatives Patrick Kennedy (D-RI) and Tim Murphy (R-PA).

The Steering Committee briefings are now being produced by the HIMSS Foundation’s Institute for e-Health Policy. For more information on future briefings, contact Neal Neuberger, Executive Director for the Institute at or go to the web site at For copies of the eHealth Initiative Survey, go to