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April 13, 2010

Healthcare IT in Practice: Notes from the field

Healthcare is a complex topic, just ask anyone about their last major surgery or visit to the doctor’s and suddenly you find yourself in a discussion where foreign-sounding words and acronyms are being thrown around. Toss into the mix the topic of information technology and it’s no wonder the current debate and discussion around Health IT becomes exponentially more confusing.

A couple of weeks ago in DC, I was part of a panel discussion on Health IT in the context of the current federal health initiatives and its desired outcomes. We had a solid panel spanning experts on Health IT standards to those that have led projects to provide more reliable health care delivery through the use of technology.

Panelists were:

- Dr. Steven Galson who was the acting surgeon general of the United States (2007-09) and is currently the operations manager for SAIC’s Civilian Health Organization

- Mr. David Walsh who currently chairs the MITA Technical Architecture committee and is president of eServices Group

- Mr. Raymond Sullivan who was the Executive Director of the Veterans Administration Office of Information Technology and is now the VP of Health IT Solution at General Dynamics

The discussion kicked off with some candid comments on the definition of “meaningful use” and the general confusion by both public and private sector on how the regulations translates into the day-to-day operations of providers and payers.


After noting the elephant in the room the session moved to a more constructive look at the opportunities for technology on improving health care delivery and reducing costs.

Key ideas from the discussion included an emphasis on the importance for a standard so that health information can be securely and efficiently exchange. The standards do not have to be perfect, but it needs to be consistent across the entire health care supply chain.

At the same time, while the standards for data exchange are developing, it became quickly apparent there will be need to figure out how this information will be used. Pilot applications need to built using these standards to make sure that the information exchanged is not just something machines can process, it also practitioners can understand and citizens can easily access.

Raymond Sullivan who has led initiatives in health information sharing at Veterans Affairs recommended that besides adopting technology standards, it is important to identify a cross-organizational team of early adopters to get feedback on how people will use the information to deliver better health care. The interactions between different practitioners, payers and patients are so complex that having feedback early and often is important to ensuring strong adoption when the solution is rolled out.

David Welsh highlighted the solutions he has seen developed on top of the standards by the vendor community, Adobe being among them.

The 40 minutes of panel presentations was followed by 25 minutes of active discussion. It was clear that everyone believed that IT was critical to enabling improved services delivery and efficiency in the health care industry.

I was encouraged that the conversation was more on how people will use health IT instead of a discussion focused solely on the movement of data from one system to another.

Frankly, it is this aspect that is critical to realizing the full impact of health information standardization. When I talk with people from Janus Health, St. Vincent Hospital, and PruHealth, it is the ways in which electronic medical information is being used that results in the realization of benefits.

Ultimately it is about the people who deliver or receive health care. I hope that in the discussions around technology and regulations, we continue to remember this and focus on:

- ensuring everyone can easily get access to their own own health information in a way that is easy to understand

- provide easy-to-use tools to manage the health and medical status of individuals whether these are tools are used by practitioners or the patients themselves.

- enable sharing of aggregate or anonymous cases between communities of health care providers so that there is a culture of learning and sharing of relative expertise

- streamlining claims and administrative processes to ensure that the greatest portion of each dollar spent on health care supports the services delivered, not the administrative overhead.