Health Care Reform (11): IT investments propel U.S. health care system into the 21st century

This is the eleventh in an ongoing series of posts examining the Affordable Care Act, including previous posts on state insurance exchange flexibility and rate review. For links to all previous posts and additional resources, please visit the health care reform page on our website.  If you have thoughts on health care reform, we encourage you to comment below or contribute a guest blog.

Over the last decade, many American businesses have radically transformed their operations with networked, computer-based processes,  yet health care is one of the few industries that still relies primarily on paper records.  To address the technology gap in the health care professions, the new federal health care law contains several provisions aimed at modernizing the American health care system.  The Patient Protection and Affordable Care Act makes substantial investments in health information technology and introduces new regulatory standards for their adoption.  This post explores how these new requirements and closely affiliated initiatives like the HITECH Act, part of the American Recovery and Reinvestment Act in 2009, are being used to improve the quality of health care in Oklahoma.

Chief among the new health IT initiatives are efforts to speed the adoption of ‘electronic health records’ (EHR).  The Affordable Care Act asks that health plans and providers begin to develop procedures and build capacity for the secure electronic exchange of health information.  Through grants and bonus payment incentives, eligible providers can offset the costs of upgrading computer infrastructure and training staff to be EHR capable.  Medicare and Medicaid providers that demonstrate ‘meaningful use’ of EHR technology by October 2012 are eligible to receive bonus payments.  Oklahoma was the first in the country to award an EHR incentive payment to an eligible provider.  This short clip features Drs. Melissa and Jeffrey Gastorf demonstrating EHR-use at their clinic in Durant:

How does EHR adoption improve the quality of care?  Electronic health records reduce paperwork, lower administrative costs, and help prevent medical errors.  They also free-up clinical staff to focus on what matters most – direct patient care activities.  While EHR are still fairly new, evidence supporting the touted benefits is already mounting.  The New England Journal of Medicine released new research showing that practices with electronic health records had significantly better outcomes in treating patients with diabetes than practices using paper records.

EHR adoption alone is not sufficient to enable patients, doctors and hospitals to fully realize the benefits that emerging technologies offer.  Equally important is the larger IT infrastructure that electronic health records are embedded within.  For instance, your personal electronic health record is of limited use if your primary care physician isn’t able to swiftly and securely share that information with a hospital for a scheduled surgical procedure.  The transmission of healthcare-related data among hospitals, doctors offices, patients is known as ‘health information exchange‘ (HIE).  Organizations that oversee and facilitate the exchange of health-related information among different users according to nationally recognized professional standards for the integrity and confidentiality of information are known as ‘health information organizations‘ (HIO).

One such Oklahoma organization that is revolutionizing the way the medical community gathers, accesses, and transmits information is the Tulsa-based non-profit MyHealth Access Network.  MyHealth Access Network is a coalition of over 50 health care organizations in northeastern Oklahoma united by the goal of improving patients’ health and the quality of their health care.  With a grant from the Office of the National Coordinator for Health Information Technology, MyHealth encourages greater communication and coordination among providers through expanded use of health information technology and health information exchange.  MyHealth hosts a secure platform for authorized health professionals to access and share patients’ health information.

There are countless benefits to sharing health information via a seamless and secure electronic communication platform, but MyHealth focuses on three activities that create a ‘virtuous cycle of health improvement.’  The first is collecting and aggregating community-wide health data, a key first step in closing gaps in health disparities among different populations.  The second is supporting care providers in making clinical decisions by providing real time indicators of patient health along with tools that help identify opportunities for care improvement or risk reduction.  For instance, a doctor viewing an electronic record of a patient’s heart rate, blood pressure, etc. could be alerted by a diagnostic tool if that patient were showing several simultaneous risk factors for cardiac distress.  Lastly, health information exchange improves care coordination tools by helping healthcare providers immediately communicate with each other about appropriate next steps – like follow up appointments, needed lab work, or referrals to a specialist.

Improving these three activities – data collection for public health, clinical decision-making, and care coordination – clearly demonstrate the value added of health information exchange.  Health care stakeholders (and that’s all of us, really) can’t afford to get left behind by the digital revolution, especially when we see how similar technology has transformed other less vital industries like shipping or retail.  The investments in IT made by HITECH and the Affordable Care Act are a small but important stepping stone to what will hopefully be the beginning of an overhaul of our health care systems’ antiquated approach to record keeping and information sharing.