A survey of key executives at the World Health Care Congress says 79% feel IT is effective in holding down costs and improving patient safety and care.
While the health industry has long been looked at as an information-technology laggard, nearly eight in 10 health-care executives at an important health-care conference say IT is key to controlling rising health costs and improving quality of patient care, according to a new survey. However, the health-care industry still faces many challenges, including expense, culture, and lack of standards, in mass adoption of many promising technologies that can reduce medical mistakes.
A survey of 106 executives from health insurers, hospitals, drugmakers, and large employers attending the World Health Care Congress this week in Washington showed that 79% believe IT is effective in containing costs while implementing patient-safety and quality-care improvement guidelines recommended by the Institute of Medicine.
"Health care has always been a slow adopter of technology," says Dr. Peter Kongstvedt, VP of Cap Gemini Ernst & Young's Health Consulting managed-care practice.
However, investment in key technologies--particularly computerized physician order-entry systems--is becoming "increasingly more important," for many providers, says Kongstvedt. That's because such systems can greatly reduce errors related to prescription orders by red-flagging possible adverse drug interactions and allergies and eliminating mistakes caused by illegible handwriting.
Dr. George Thibault, VP of clinical affairs at Partners Healthcare, which has a physician network of more than 3,000 doctors and operates several Massachusetts hospitals, says CPOE has reduced drug-related errors by 50% to 80% in its Massachusetts General and Brigham & Women's hospitals since being rolled out.
However, the rollout of CPOE and other technologies won't improve patient safety on their own, Thibault says. "Technology alone wasn't going to do this. We needed to focus on cultural changes as well over the last three years," he adds.
That includes weekly "leadership patient-safety walk-rounds" in which top Partners Healthcare officials, such as chief medical officers, chief nursing officers, and others, talk to front-line care providers in the facilities. Those leaders ask questions and collect comments and information about events affecting patient safety. Partners Healthcare has compiled a database related to this information and recently decided to move to a Web-based reporting tool to create a standard method of collecting this data, Thibault says. The walk-rounds are meant to be "nonpunitive," so most mistakes are addressed as "system flaws" rather than having individuals "carry the burden," he says.
As for health-care industry executives' overall beliefs that IT can improve patient safety and cut costs, the actual investment in technology itself is still a challenge, Kongstvedt says.
For instance, individual physicians often are unwilling to spend on technologies for their practices, such as handheld E-prescribing devices, because of the expense involved. Due to cutbacks in reimbursements from federal health programs like Medicare, as well as fee freezes by health insurers, "doctors have seen their incomes decline over the last five years," Kongstvedt says.
Other challenges in reducing medical mistakes and improving patient care nationally through IT are due to the lack of national standards for reporting, collecting, and sharing patient information, says Dr. Paul Tang, medical information officer at Palo Alto Medical Foundation and chair of the Patient Safety Data Standards Committee at the Institute of Medicine, which released a report in November that recommends industrywide adoption of electronic medical records and other technologies.
Tang says the health-care industry needs to do better in collecting and reporting data about adverse effects suffered by their patients, "as well as near-misses and other incidents" to learn and improve industry practices. However, "the only way to have a national database is have national standards," he says.
Tang says the health-care industry might benefit by following examples in the air-transportation industry, which relies heavily on technology and government mandates both in day-to-day operations and the reporting and analysis of safety problems. This can lead to better ways of preventing problems in the future.
"There's an enormous infrastructure in air traffic that helps you feel safe," he says. "Computers help air traffic work around problems like weather, and computers support human decision-makers. It's nice to learn why crashes happen, but it's even better to prevent them from happening. Unfortunately, he says, in health care, "the infrastructure is often mountains, walls of papers."
George Halvorson, chairman and CEO of Kaiser Foundation Health Plans, which has implemented automated electronic-health records in its organization, told World Health Care Congress attendees on Monday that doctors won't have the tools to deliver "consistent, quality care" without access to electronic patient information at the point of care. "The nation's health-care delivery system will not get better without that tool," he says.
Government officials and legislatures also favor the use of electronic health records and computerized physician order-entry systems by the country's health providers. President Bush also promoted the use of computerized medical records in last week's State of the Union address. And at the World Health Care Congress on Monday, Senate majority leader Bill Frist, R-Tenn., who also is a doctor, admitted to attendees that the U.S. health-care industry's use of technology, compared with its use in other business sectors, "is in the Dark Ages." He says public policy makers and the federal government need to step in with incentives and standards that help health-care providers adopt technologies like computerized physician order-entry systems and electronic medical records.
"Electronic medical records reduce mistakes, improve quality, reduce costs, red tape, and paperwork," Frist says. In addition, information about medical mistakes needs to be collected electronically in a way that allows "doctors to share information for best practices without fear of lawsuits."
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