Sunday, January 25, 2009

Health IT Comment

On December 6, 2008, President-elect Obama mentioned in a weekly address that a key part of his Economic Recovery Plan would: "ensure that our hospitals are connected to each other through the internet. That is why the economic recovery plan I’m proposing will help modernize our health care system – and that won’t just save jobs, it will save lives. We will make sure that every doctor’s office and hospital in this country is using cutting edge technology and electronic medical records so that we can cut red tape, prevent medical mistakes, and help save billions of dollars each year".

Recent reports indicate Obama is considering a 50 billion dollar infusion of tax monies to implement these Health Information Technology initiatives which would include the ubiquitous electronic medical records mentioned. If one wishes to gain a brief overview of this subject, I highly recommend the Congressional Budget Office's 46 page, relatively easy reading primer entitled "Evidence on the Costs and Benefits of Health Information Technology".

What I fail to understand is why already established software and frameworks are not being considered as templates for the future needs of our broken health care system. I am referring to the VA and DoD computerized systems that do rather effectively integrate the essential needs of each organization. As with any IT program, both respective vistA and AHLTA systems do have their detractors from a clinical and administrator perspective. Yet, speaking as an Army Reservist clinician who has used the various forms over the last decade, I can speak quite candidly that my experience with the DoD programs of CHCS and AHLTA allowed me to see the future of civilian healthcare. Access to a patient's entire medical record from across the globe to having an up to date medication listing to being able to correspond with and immediately refer to consultants for any given problem seems, to my simplistic world view, that the nature and evolution of a similar civilian-based application should be quite easy to adapt from applications already in use. Essentially, why invent the wheel? Why not "tweak" an established product and save potentially billions of dollars?

I found it interesting given my train of thought that on January 15, 2009, Peter Neupert of Microsoft Corporation’s Health Solutions Group testified before the Senate Committee on Health, Education, Labor, and Pensions Hearing on "Investing in Health IT: A Stimulus for a Healthier America". I read his testimony and he and I do agree that proper applications of IT offer great benefits for the future of US health care in general.

A very good friend of mine at the Foreign Military Studies Office, Ft Leavenworth once admonished me that the key to analyzing another country's domestic and foreign agenda and subsequent policy is to "follow the money". As a clinician not in uniform and a prospective US Senate candidate in 2010, I have to wonder whether our taxpayer monies will truly be spent effectively and in good stewardship in this particular agenda of health care. It seems that billions of dollars are up for grabs in this case. I suspect that Microsoft's representation at the aforementioned Senate hearing is more than just an altruistic affirmation that our health system is in trouble. Corporate interests for some reason tend not to be in sync with either patient or provider interests and I can share 20 years of experience acknowledging that reality.

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