Talk Radio News Service: News, Politics, Media

Coffee Brown, University of New Mexico, Talk Radio News

The Alliance for Health Reform presented findings of recent pilot studies showing that major improvements in healthcare are possible now, even in advance of new technologies and structures.

Ed Howard, Alliance for Health Reform, said that less than two percent of hospitals have “fully integrated” Health Information Technology (HIT). Even as hospitals invest in hardware, software, and training, the systems won’t work unless everyone uses them, he said. Where HIT is used effectively, he finished, quality and cost control are measurably improved. In other words, HIT does deliver better, faster, less expensive care.

But only when its use is coordinated among providers (often called “Care Teams”), according to Carolyn M. Clancy, MD, Director of the Agency for Healthcare Research and Quality (AHRQ). When the Electronic Medical Record (EMR) merely recreates the chart as an electronic document, “it can actually allow us to make the same mistakes faster.”

She cited the Provnost Study showing that when computers helped to coordinate care among all of the caregivers, using checklists, prompts, and feedback, infected lines in the ICU were reduced nearly to zero.

Jon Rasmussen, Pharm. D., Chief of Clinical Pharmacy Cardiovascular Services, and Susan Kuca, RN, Cardiac Care Coordinator, described Kaiser Permanente’s intricately coordinated care. They said the program had reduced the risk of subsequent fatal heart attack by 88 percent if begun immediately after hospitalization, and by 73 percent even if started much later, such as when a patient with existing heart disease came into the system from elsewhere.

Greg Halvorson, Chairman and CEO of Kaiser Permanente Health Plan, said we are the only industrialized country without universal health care. He said healthcare can and should be both better and more affordable. Halvorson described a RAND study covering 5 million patients over 2 years that found 25 percent of care was wrong or harmful, implying that U.S. savings in healthcare from efficiency alone could be one-half to one trillion dollars.

Diabetics account for 30 percent of Medicaid dollars, yet their carewas rated as “right only eight percent of the time.”

Big deductibles had the opposite of their intended effect by causing beneficiaries to delay care too long, he said.

In the case of chronic care, one percent of patients use 35 percent ofthe dollars, and ten percent use 80 percent of total dollars. “Chronic
care is a team sport,” Halvorson said.

The consensus of the panel was that, even without a single new treatment or device, coordination of ongoing care could save billions
or trillions of dollars, while improving outcomes.