The next big HIT: Health Care IT saves money and lives
By Montana State Auditor John Morrison and Dr. Mike Schweitzer
Health insurance and Medicare have something in common: they are buckling under the weight of rising health care costs. Their future depends on controlling these costs. There is no better single step we can take toward this end than the widespread adoption of electronic health information technology (HIT). It will revolutionize medicine by slashing costs while saving lives.
America has the most advanced medical technology in the world for diagnosis and treatment. Yet we waste billions of dollars and lose tens of thousands of patients each year because we still store and move critical medical information the old fashioned way—on paper.
You know the routine: You walk into a doctor’s office or hospital and fill out a form asking you to report your medical history, allergies, and contact information. The form goes into a chart that sits with hundreds of others on a shelf. When the doctor opens it, she finds a mixture of typed and scribbled notes, reports, results and memos. The doctor depends on you to know and provide accurate history. If she wants your records from another physician, she calls that office and they send copies over, assuming you have signed a release. If medicine is prescribed, you’re a given a handwritten slip that you take to the pharmacy.
Among providers, charts are often incomplete, redundant and contradictory. The thicker the chart, the more confusing it is. Emergency rooms often have nothing to go on at all. This system results in lower quality care and massively higher costs because of repeated tests, misdiagnoses, errors, and complications causing longer hospital stays.
HIT is a safety issue. The Institute of Medicine says that as many as 98,000 Americans die every year from medical errors. Many of these are related to inadequate or inaccurate information. Last year, 68 year old Frank Morrison became one of these statistics. HIT will save countless lives by giving doctors fast, complete information about your medical history, your condition and the treatments you need.
HIT will also save money by improving efficiency. America's economy blossomed in the 1990s because the technology revolution super-charged whole industries. Costs went down and quality went up. Unfortunately, the same strides have not been made in the health care sector.
Studies say that a third of the money we spend for health care in the U.S. is for tests and treatments that may be unnecessary, redundant or inappropriate. HIT will prevent such waste by giving doctors accurate patient history and by tracking the effectiveness of procedures.
HIT will help providers cut administrative expense by streamlining the process of billing insurers. It will also allow us to reward doctors who keep patients healthier and who adhere to best practices for treatment.
Electronic medical records (EMRs)—a key part of HIT--are used by 9 out of ten doctors in other countries, but only by 28 percent of U.S. physicians. Some Montana hospitals and their provider groups are now adopting new HIT systems, but they differ from group to group and need to be woven together so they can communicate with each other.
The financial services industry--insurance, securities and banking--now invests seven percent of its budget in IT; the health care industry invests only three percent. Other major countries spent between $5 and $192 per person in 2005 on HIT. The U.S. spent 43 cents. Although some providers are reluctant to make the investment in EMRs, those doing so have recouped the cost in just a few years.
The federal government has ordered medical billing to convert to electronic systems and has created a grant program to support HIT projects. Montana is slated to be one of the first grantees. The Montana Health Information Taskforce has been formed at Senator Baucus' request. The Utah Health Information Network has already streamlined billing procedures there and Delaware just launched a state-wide network to connect all major sources of patient clinical information.
There has been some activity and leadership on this issue during the current Legislative session. State Senator Kim Gillan is the sponsor of S.J. 19 which urges legislative support for HIT efforts. Both houses have considered a budget amendment seeking to partially fund a pilot program in HIT. Hopefully, both will pass.
Fixing our broken health care system is a puzzle with many pieces. Containing costs is the biggest piece of all. It is heartening to know that the best way to save money in health care is also a great way to save lives.
John Morrison is the elected Montana State Auditor and Commissioner of Insurance and Securities.
Dr. Mike Schweitzer is a past president of the Montana Medical Assn. and an executive committee member of the Montana Health Information Task Force.