Technology & innovation can check rising health costs


This week, more than 150 sponsors of Health IT week came together to share our thoughts about the cost saving and quality enhancing potential of health information.  Our idea is that technology and innovation can help reduce health costs or, at least restrain the rate of growth, without diminishing the availability or quality of care.
 
Three major advances have been in the areas of electronic health records to document and provide priceless information for patient care and coordination, tele-medicine, and in-home monitoring – all of which are becoming more mainstream tools through private investment and cultural change.
 
Patient record keeping has traditionally been a labor-intensive activity.  Typically, the task of filling out piles of forms and often duplicate, missing or redundant information has fallen on the patient, offices scribes or managers.  Doctors dictate observations, orders or referrals that is transferred to a series of forms and charts which are placed into a folder that joins a wall of other color-coded charts for other patients. 
 
Along the way the physician has scribbled a prescription which the patient carries to their pharmacist who reads it, enters it into a computer system, fills it and hands a plastic orange bottle back to the patient.
 
To help combat the ever-increasing “back-office” costs of running a practice, more and more doctors have joined together to shoulder the burden collectively.  It is not at all unusual to see more clerical staff than medical staff in even a small joint medical practice.
 
The major issue in automating patient records has been the inability of different systems to “talk” to each other so the records of a patient who lives in Minnesota can be read by the medical staff in emergency room visit while the patient is on vacation in Florida.
 
The simple fact is these mounds of paper and countless hours of tasked labor cost our system dearly.  According to the Lewin Group, about $200 billion is wasted on administrative inefficiencies.  Ingenix estimates $30 billion in annual costs of paper remittance advice, checks and claims for services.
 
With broadband enabled EHRs, records can be managed and accessed with safety, security and speed, but more importantly, with confidence that nothing has been lost “in translation” from one medical office to another.  This allows medical professionals to concentrate on the needs of the patient, while practicing high value, quality medicine enhanced by clinical decision support through an EHR.  The payoff?   $260 billion in reduced variation in care delivery. 
 
Improved tracking of what was delivered to who and when will make health care fraud, a burgeoning growth industry, less likely.  We’ve just saved another fraction (3 to 10 percent) of the $260 billion in annual fraud losses.
 
The other significant development with the advent of broadband is the fast-growing area of tele-medicine.   As the equipment of medicine becomes more expensive and its deployment is more centralized, the access route to the benefits of new technologies has been to travel to a major medical center whether they live a few blocks or hundreds of miles away.
 
The result has been a method of health access largely defined by accidents of geography.  The haves – largely in major urban centers or suburbs; and the have nots -- largely in rural areas.
 
With high-speed access to the Internet, patients in small communities can have access to the most modern medical technology right from their local hospital or even a doctor’s office. Private industry continues to develop end-to-end solutions, which allow the major medical centers to better utilize their capital investment in new equipment, while allowing local doctors to deliver better medical care to their patients.
 
When a procedure does have to be performed in major medical center, follow-up care is improved by allowing the surgeon or specialist to see the patient from the patient’s home medical facility, reducing or eliminating a long, sometimes painful or dangerous trip to the medical center.  Patients may be more likely to adhere to a treatment plan if they have a more convenient, less painful, local option.
 
Our aging population is a major contributor to national health care costs.  Regular patient monitoring of certain vital signs are another potential cost saver.  The ability to track a patient’s vitals through the use of automated, inexpensive devices linked to the Internet through broadband connections can save more expensive physician or hospital visits, and the data can be loaded directly into an EHR to monitor potential problems.
 
These changes will not be easy.  We would do well to develop EHRs with significant input from medical professionals, the ultimate end user.  Linking the system through broadband enabled technology will be key to use as well.  Ever wait for a movie to download?  Physicians don’t have that kind of time when treating a patient.
 
But the payoff can be substantial.  In this short article, we’ve identified almost half a trillion in potential savings.  Quality of life and health outcomes are not measured here, but the value to a patient can be beyond price. 
 
Joel White is the executive director of the Health IT Now Coalition and a member of the health care working group for Broadband for America.