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Cities Lead on Health Info IT

Future Cities
Tuesday, February 19, 2013 10:00 EST

10 comments
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ldjsfljeoiw
ldjsfljeoiw  
4/18/2014 7:18:47 PM
User Rank Village Voice
Great stuff
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vhasfcleep
vhasfcleep  
2/22/2013 7:44:07 PM
User Rank City Slicker
Re: Great graphic
The government can certainly provide incentives, but without a clear set of guidelines and expectations, the outcomes may leave much to be desired. The diversity and availability of EHR providers probably correlates with the number of health insurance providers, with little interoperability between them. With each system purchased, maintenance costs including software updates, data backups and storage, and expanded databases need to be considered. Infrastructure to support all this can also be considerate. Security measures to protect all of the above add to the overall cost.

If a regulatory agency such as Health & Human Services were to mandate standards, conventions and interoperability between EHR systems such that any patient, licensed physician or authorized health care provider can access an individual's health record at the click of a blue button, we would certainly see enormous cost and time savings. Patients would not need to retrieve their health records from one agency, institution or provider to another by contacting such, making a formal, probably written request, paying for such and having it sent to a new provider. Doctors in emergency rooms would be able to retrieve comprehensive health records on patients with identification and without the wherewithal to provide an accurate accounting of their health histories. A single, comprehensive cradle-to-grave integrated EHR system, something akin to a single payer system in terms of health insurance, would have considerable startup costs, but would certainly bring down the costs of health information IT.

The Interagency Program Office is currently coordinating efforts between the Department of Defense and the Veterans Administration to implement a working iEHR. The pilot is in place at a North Chicago Health Care Center which is a facility integrating a VA and a couple of military hospitals in the area. An individual's health record typically includes demographics, health incidents related to military operations, follow-up at military health centers, military separation followed by enrollment at a VA facility, and all subsequent treatment at the VA or any other VA, should the individual move around the country. Post-mortem follow-up benefits are also part of the record for the patient's next of kin.

Imagine if this approach was applied to all private and public EHRs. With comprehensive healthcare, insurance and tort reform, and in conjuction with focused patient education via the numerous online resources available, we would be one step closer to a better, cheaper standard of care and to real civilization.

Mary Jander
Mary Jander  
2/22/2013 6:14:52 PM
User Rank Staff
Re: Great graphic
In any funding exercise, it's always a big question about what was left off the table. It bothers me sometimes to think that some great ideas are either getting ignored, or being swiped for use by someone for another purpose. IT vendors like Google have sponsored contests, for instance, to get proposals. One wonderw where all the ideas ended up.

 

Nicole Ferraro
Nicole Ferraro  
2/22/2013 6:12:40 PM
User Rank Staff
Re: Great graphic
Too true, Mary. I was thinking the same when watching the videos from the Mayors Challenge and wondering if there were better ideas out there that just didn't make the cut because they weren't produced or delivered as well.

Mary Jander
Mary Jander  
2/22/2013 2:28:47 PM
User Rank Staff
Re: Great graphic
I'd love to see a breakdown of costs, Hazel, In most of the Beacon Communities, the electronic records have been implemented as part of a specific kind of project focused at monitoring and informing/educating patients with certain kinds of ailments most common to the community -- ie, heart disease or diabetes.

This is just one aspect of what healthcare IT is supposed to be.

Mary Jander
Mary Jander  
2/22/2013 2:26:43 PM
User Rank Staff
Re: Great graphic
It's not clear to me why Detroit fared so well in receiving funds, Nicole. But as with every government funding program, grants must be applied for in a process that may or may not work for certain applicants. Money is available, but it's often an art as well as a science to actually obtain funding of any kind from the federal govt.

Ever heard the saying, "We hired (her, him) because they're great at grant-writing"?

Mary Jander
Mary Jander  
2/22/2013 2:12:24 PM
User Rank Staff
Re: Great graphic
It's clear to me that more is needed for real healthcare IT savings than simply automating records. That should save costs if the records are networked properly. And sure, it's going to cost something up front to get records digitized.

Once a system is in place, though, I think real savings will accrue from a combination of proactive actions taken as the result of analytics, mobile apps patients can use in place of office resources, and telemedicine. We're a way from having any of this, even in facilities that are showing good progress in electronic recordkeeping.

Hazel
Hazel  
2/21/2013 8:52:32 AM
User Rank Urban Legend
Re: Great graphic
This is informative in terms of showing us how much the government has slated for healthcare IT. What would also be interesting if we had a breakdown of sorts with regards to where this money is going or how it's being used.

arv
arv  
2/20/2013 7:12:41 AM
User Rank Village Voice
Re: Great graphic
I agree the amount budgeted and the eventual expenses of the IT will more due to  policy changes, more infrastructure. 

This inforgraphic captures the amount spent by the govenrment and patient, which is very important.  Whenever there is a discussion on the usage of cloud sevices for eHealth records or EHR initiatives I was skeptical of the savings. I was always of the opinion that any introduction of technology (be it equipments or documentation) would be additional cost on the patient, but I am surprised to see that IT has resulted in 35% increase in costs.

Nicole Ferraro
Nicole Ferraro  
2/19/2013 3:57:43 PM
User Rank Staff
Great graphic
This graphic really does a nice job of demonstrating the situation in the US where healthcare IT is concerned. I was surprised to see how much healthcare costs have increased, when they were expected to decline.

The perceived value of IT is often overestimated. Too often we consider what the tech is capable of and make projections from there, without considering the human element in any of this. But if providers and patients aren't ready, or properly educated, and if the government isn't doing its part to make this kind of evolution easier, the tech isn't going to move forward on its own.

Let's hope the cities involved in the Beacon Community effort can help us move forward here. One thing, I was surprised to see Detroit receive the most in funding. I wonder why that was?

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