01.10.08

Whitehouse, crusader for electronic health care records, lauds Kent system

After U.S. Senator Sheldon Whitehouse (D-R.I.) viewed the state-of-the-art electronic health records system at Kent Hospital Tuesday afternoon; he pointed out a fact that would startle most people.

“There’s only one industry in the nation that’s further behind the health care industry in using information technology, and that’s the mining industry,” said Whitehouse.

This means a person can walk into a bank at any given time, apply for a loan, and have their credit history made available on the spot. A person’s student transcripts can be accessed in a number of minutes. And Wal-Mart uses information technology to tell its employees which cereal sells better just before a snowstorm.

But doctors trying to help injured or sick patients cannot access the records of a person who visits the emergency room for the first time.

This lack of access to information creates big problems for doctors, and insurance companies alike, and threatens the safety and wallets of patients.

Financially speaking, the lack of a centralized information center which provides a patient’s medical history can lead to patients being tested numerous times for the same problem. For instance, a primary care doctor may conduct a blood test on a patient, and then recommend that patient to a specialist.

The specialist, without access to the results of the tests by the primary care physician, may then be forced to then perform the exact same test on a patient. For many, this is believed to be one reason health insurance costs have soared over the last two decades. Some studies show that 15 to 20 percent of all tests performed by medical doctors wouldn’t be necessary if better information technology existed.

But the lack of information also proposes a threat to the health of patients. If a person enters the emergency room and is unconscious, the doctors currently have no way of knowing what, if any, allergies a patient has. Even a lucid patient could conceivably forget to mention an allergy to a doctor, and be prescribed something the patient could have an allergic reaction to.

“This is a quality issue. This is not something that’s a luxury. This is a necessity,” says Dr. Michael J. Dacey, who runs the Intensive Care Unit at Kent Hospital.

So why has the health care industry lagged behind practically every other industry in developing information technology?

The answer lies in the wonders of a third party payer system.

While the costs for implementing this type of technology falls into hands of the doctors and providers, the savings would fall into the laps of the insurance companies. The cost for implementing the system for a primary doctor with a practice is usually somewhere in the ballpark of $20,000, not to mention the time it takes to implement a system and enter information.

The insurance company, on the other hand, usually assumes none of the costs, but reaps a lion’s-share of the savings.

“That’s the big question,” Whitehouse said following a tour of Kent’s intensive care unit. Whitehouse watched as Dacey pulled up patient information from workstations on wheels. He was able to review medications taken by the patient, charts and graphs, test results, physicians’ comments as well as a medical history.

“The medical providers have to be prepared to make the investment. That’s the battle we’re up against—how to make it economical for doctors,” said Whitehouse.

Officials at Blue Cross Blue Shield of Rhode Island have recently begun a program that gives doctors an incentive to begin using the information technology to everyone’s advantage. Blue Cross now reimburses doctors at a higher rate if they take on the initial costs to implement the technology.

Dr. Hebert Brennan, D.O., who practices internal medicine in East Greenwich, has already taken the initiative and implemented the information technology in his office. Brennan is connected with the system at Kent, which makes his work, as well as that of the hospital, easier.

Though he had to take on the costs himself, the system has saved him a lot of time, and in the medical profession, time is money, Brennan said.

“The vast majority of physicians are paid on a fee for services basis,” said Brennan. “We have to be efficient with our time so the technology is very useful.”

During his tenure as the state’s Attorney General, Whitehouse founded the Rhode Island Quality Institute, which seeks to improve, and implement, the use of information technology in the health care industry.

The work of the Rhode Island Quality Institute focused attention on the benefits of information systems. Care New England, which runs three hospitals, chose the Cerner Corporation to implement the system at Kent, Women & Infants and Butler Hospitals at a cost of about $30 million.

With that system, doctors are creating a reliable database that tells them all the vital information with regard to a patient’s history.

Whitehouse said he was happy to see Kent Hospital, and the state in general, making progress. Kent and Rhode Island Hospitals are considered to have the two most technological systems in the state.

“It’s great to see what they’ve done here at Kent,” said Whitehouse.

“This is an issue where Rhode Island is ahead of the rest of the country. We are real innovators in this.”

Whitehouse is plugging this effort on a national level. After visiting Kent on Tuesday, he drafted a letter to President George W. Bush asking him to increase the amount of federal funding allocated toward implementing information technology in the health care industry.

“Your FY 2008 budget request for the office of the National Coordinator [of health and information technology] was only $118 million. I strongly urge you to vastly increase the funding level and make health information technology a top priority in your FY 2009 budget,” Whitehouse wrote.

But the issue of implementing information technology in the health care industry has bipartisan support—at least on the state level.

One of Republican Governor Donald Carcieri’s biggest health care initiatives has been the implementation of health care technology.

Jeff Neal, the governor’s spokesman, summed it up a few weeks ago while talking about the issue of health care in general.

“From the governor’s point of view, we need to look at ways to reduce health care costs so health care becomes more affordable for everyone. That’s why the governor’s health care agenda has centered on using opportunities like health care information technology and planning of health care facilities to begin to drive down costs, or at least reduce the rate of growth,” Neal said.

Dr. David Gifford, M.D., who serves as the director of the Department of Health, has been working to implement the use of information technology on a statewide level.

“Medical care is, at its core, an information-based service. The decisions made by physicians are based on the flow of information,” said Dr. Gifford.

“Health care is the last major industry that relies on paper and pencil. When you see a doctor, he needs to know your medical history.”


By:  Russell J. Moore
Source: Warwick Beacon