Digital Health Care...How to Play It?...BusinessWeek

[CC-Conrad Clyburn-MedForeSight]

Colleagues,

As reported in BusinessWeek...The bulk of President Barack Obama’s health information technology stimulus spending breaks down into two distinct streams: One, to hospitals, the other to private physicians. Two somewhat different groups of companies will be rewarded, says Jeff Goldsmith, a health-care consultant and author of Digital Medicine: Implications for Healthcare Leaders.

Hospitals will receive millions to go digital. Goldsmith says companies that sell large-scale medical record systems, including such majors as McKesson, General Electric, and Siemens, will get a boost. This group also includes one pure-play stock, In 2008, Cerner, based in Kansas City, Mo., generated about $1.7 billion from sales and upkeep of hospital-installed electronic records gear and software, in 2008.

The other big funding stream will be steered to the physician community. Only 38% of U.S. doctors use electronic records, according to a 2008 survey from the National Center for Health Statistics. The stimulus bill will spur recruits by awarding them bonus payments of up to $65,000. That will help Athenahealth in Watertown, Mass., whose billing network is used by more than 17,000 medical providers.

Drug prescriptions are also going to change. Fewer than 5% of those written in the U.S. are transmitted electronically to pharmacies. One beneficiary of increased ePrescribing: Allscripts-Misys Healthcare Solutions of Chicago, whose software is the most widely used by doctors and hospitals.

Read on at:http://www.businessweek.com/blogs/personal_finance/archives/2009/02...

ENJOY!

CC

[Michael Liebman]

All
While I strongly support the efforts of the new administration to take on the challenge of upgrading the healthcare
system by increasing the use of electronic medical records to capture more comprehensive and consistent patient data, it is clear that the need is well beyond just reducing errors and waste in the system- and I am concerned that the big players, as noted above, will benefit from this technology push with much more limited benefit to the patient and the physician-
Firstly, I believe that it is critical that the data that is to be collected exceeds that of the conventional EMR and establishes a true PHR (personalized health record) with not only detailed family history but lifestyle and environmental factors, captured at a granularity that is much greater than currently anticipated. This will be critical to support the identification of risk factors that develop over a person's lifetime and the much needed evolution from clinical decision support being focused on disease management to becoming one focused on health management. I believe that the expriences we generated within the Clinical Breast Care Project (Walter Reed Army Medical Center and Windber Research Institute), supported by TATRC/DOD and under Congressman Murtha's leadership, provide evidence of the value of this type of extended data collection
Secondly, and perhaps more to the point of converting the EMR into true actionable items for the patient and physician, the emphasis should be on data analysis and interpretation, not just data generation- of course the right data must be collected as noted above, but the only way this will evolve into care improvement and cost reduction will be through the extensive analysis and interpretation of the data relationships, beyond correlation to causal analysis, with integration of molecular characterization BEYOND JUST GENOMICS, and the conversion into actionable items. As noted, this will start with disease management but hopefully will evolve into health management-
This is a critical point in time for changing the infrastructure and results of healthcare and healthcare research- we must all work diligently to plan this appropriately and not solely look to the immediate financial benefits of the economic stimulus that can provide tactical but not strategic value.

[Jay H. Sanders]

I would totally agree with your comments/analysis but emphasize that we need to pay as much attention to the integrity of the information being incorporated into an electronic format. If the data input by a physician is based on an incomplete history, or as reported by a patient, is inaccurate, it doesn't matter if that is in a paper-based record or in an EHR/PHR; it is still garbage. We need to bring "collective physician" expertise to the patient's bedside by incorporating AI and branched logic tree algorithms to the information intake and interpretation phase. Comprehensive data is good, but accurate data is better.

Jay