Change we can believe in

The Huffington Post's investigation fund has been running a series of articles on Electronic Health records (required by 2014), and whether their implementation can lead to the care improvements and the cost savings envisaged by President Obama.

The President has praised the Cleveland Clinic for having "one of the best health information technology systems in the country" and holds it as a model for healthcare in America. As a result of this, the Huffington Post analysed their IT practices and how they developed and managed a system of Electronic Health Records throughout the clinic. 

The video below examines whether the experiences of the Cleveland Clinic can, and should, be replicated across the country. 

The Obama administration is current spending $45 billion to jump-start a national system of electronic medical records. They want doctors and hospitals to digitize their records within five years, as a means of improving care and achieving billions of dollars in savings.

Cost savings

WhileCleveland Clinic doctors say there is no doubt the switch to digital record-keeping has boosted the quality of care, they question whether they have saved money and reduced costs. 

The Huffington Post notes how the Cleveland clinic has invested $100 million in IT over a decade, but cost savings have not materialized and hospital officials are not certain when they will. Whether their effort of digitizing records will save money is not altogether clear. This is consistent with some recent national studies that question whether electronic records can lead to lower medical spending:

A study of 4,000 hospitals published in November in the American Journal of Medicine--carried out by Harvard researchers who are some of the most prominent advocates of a single-payer healthcare system--found no cost savings or increased efficiencies with digital records. That was consistent with preliminary results from a separate study of 3,000 hospitals by researchers at the Harvard School of Public Health, who found no evidence of cost savings with electronic records.

The switch to Electronic Health Records (EHR) has received mixed reviews at hospitals around the country. Other countries, such as the UK, are already advanced in the development of EHRs, but are having their budgets cut as a result of delays and cost overruns. The Cleveland Clinic's experience shows that while EHR's can improve the quality of care and administration, they're not necessarily a panacea for reducing high healthcare costs. 

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Cool video explaining how the Salt Lake Valley Health Department uses social media tools like Twitter and Facebook to communicate H1N1 information to citizens and media.

For more on their Web 2.0 outreach programme, check their Social Media Outreach page. 

(via GovFresh)

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The U.S. Department of Health and Human Services has launched Health IT Buzz, a new blog for the discussion of Information Technology (IT) issues, particularly electronic health records.

David Blumenthal, the National Coordinator for Health Information Technology, said on the initial posting:

With this new venture, we hope to create a forum for engagement. We plan to report on progress, and create an open dialogue among members of the health IT community. We intend to address a wide and diverse range of timely topics relevant to the “why’s and how’s” of efforts to support the secure and seamless exchange of electronic health information. We will discuss our ongoing work to protect patient privacy, secure information, and implement standards. We’ll also be using the blog to provide additional information regarding our new grant programs. And the conversation wouldn’t be complete without discussing the meaningful use rulemaking and incentive programs, clarifying our vision and addressing key challenges.

We want to hear from citizens, patients, health professionals, managers, policymakers, technology enthusiasts and technology skeptics. We can’t succeed unless we understand the wishes and concerns of the many constituencies we serve. 

Federal Advisory Committees

The first blog post has already produced a lively debate with dozens of comments from doctors and interested groups. While there is already a wide range of forums to discuss Healthcare reform, this blog differs in that it focuses specifically on Health IT. It does, however, follow on from a similar blog that has been running for the past couple of months concerning the work of the Federal Advisory Committees on Health IT. 

Aneesh Chopra - Federal Government CTO - has previously stated his ambition to uncover new strategies to accelerate the adoption of health IT standards.

"Standards" are really the guardians of quality, consistency, and interoperability.

Without thoughtful, clear and uniform standards, we cannot enable the seamless and secure exchange of electronic health information (or the benefits that accrue to providers and patients from such protected exchanges). So, while the exploration of technical standards may seem mundane to some, it is foundational to electronic health records (EHRs) and electronic health information exchange more broadly. 

In this vein, Public hearings on Health IT (HIT) Standards began earlier this year and will continue into next year. Aneesh Chopra wants all stakeholders to be able to follow the activity of the Committees and contribute to their current thinking. Consequently, members of the Health IT Standards Committee began a blog to facilitate Transparency and Collaboration in the work of the HIT Policy and Standards Committees. 

The Federal Advisory Committees blog has, and is due to focus on:

1. Proposed Standards
2. Interoperability
3. Vocabularies
4. Privacy
5. Security
6. Quality
7. Implementation Case Studies (Your Story - the good, bad and in-between)

The new Health IT Buzz and the Federal Advisory Committee blogs provide the public with a new and accessible medium in which to follow activity on formulation of policy and standards in this area. They exemplify President Obama's Memorandum on Transparency and Open Government.

The aim is for quality, consistent and interoperable standards to emerge as a result of wide-ranging, transparent discussions by all on the topics above.

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This week's This American Life has a superb analysis of the rise in healthcare costs over the past decade. The story - in four acts - looks at healthcare costs from the perspective of doctors, patients and the insurance industry.

For more on why on the cost of Healthcare see the YouTube video below.

(Photo credit:  thatmushroom on Flickr.)

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NPR's Planet Money podcast recently discussed the concept of a single-payer healthcare system with Donna Smith of the California Nurses Association and Stuart Butler of the Heritage Foundation.

During the show they mention the video below regarding why a universal healthcare system, with a single-payer would bring down costs. The U.S. Senate Finance Committee recently twice voted down the Obama Administrations so-called public option. Such a single payer system is, however, prevalent in many countries such as Canada and the UK. The arguments in the videos below give a good overview of the pros and cons of each approach.

And a critique from How the World Works

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