June 15, 2007 • Volume 5 • Number 6

Star Trek, The Holy Grail and Getting The Care Only A Mother Can Give

“It doesn’t mean you are going to be doing an appendectomy on the kitchen table, but for most of what we do in medicine, care can come to the patient,” says Dr. Karen Bell, Director, Office of Health IT Adoption at HHS.

Dr. Bell is talking about the future of health care in America.

“I think what we are talking about is a virtual health care system. It’s where the ability to get information and care for oneself, as well as get care from the most appropriate and well educated and experienced clinicians, is available where ever you go.”

Dr. Bell gave her vision of the future of healthcare during the Federal Executive Forum on Health Care IT broadcast on Federal News Radio.

“Then there is the concept of self management by engaged and empowered patients.” explains Dr. Bell. “To do more preventive care and in essence take care of ourselves in a way that in the old days our mothers used to and now we go to physicians for it.”

“Then lastly as we move to this virtual system we are going to eliminate a lot administrative costs. There are a number of published reports out there that say that 25% of our almost trillion dollar health care system is administrative, and as we move more and more to this electronic health care arena, we will be eliminating many, many of those costs which will then allow us to truly have a system that’s affordable for everyone.”

Joining Dr. Bell on the Federal Executive Forum hosted by Jim Flyzik of The Flyzik Group were:

·         Theresa Cullen, CIO, Indian Health Service/HHS

·         Charles Hume, DCIO, Military Health Service

·         Gail Graham, Director of Health Data & Informatics, VA

·         Patti Obermaier, Partner, Federal Systems, Unisys Corporation

·         Jason Kimrey, Intel Corporation

·         Max Peterson, Vice President of Federal Civilian Sales, Dell

After discussing opportunities and challenges in delivering on the promises that IT can provide the health care industry and patients alike, each gave their vision of the future of Health IT in America.

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“I think back to my teenage years when I used to watch Star Trek. Dr. McCoy always had that little thing that told him everything that was wrong,” says HHS’s Theresa Cullen. “So my vision is that at some point I’ll have a little machine like that. But in the meantime what I think the goal for Health IT is to figure out how to have an interoperable system that is patient and population centric that relies on the integration of knowledge and data so that we truly have true knowledge management within the Health IT system which we really don’t have right now.”

“The holy grail that several of us have talked about is the universally accessible patient-centric electronic record that every provider can use to facilitate the best care for their patient,” declares Charles Hume of the Military Health Service.

“But the other piece of this is that it empowers the patient too”, says Hume.

Once information is captured electronically, allowing it to be shared across the health care enterprise, the patient has the freedom to choose the providers they want and be able to facilitate things like home health care.

“The patient is able to access the health care system directly from home through the health information system,” adds Hume. “So a completely different dynamic and model for health care delivery is the future with information technology.

According to VA’s Gail Graham, the future hinges on the development of people. “About 2/3’s of medical trainees in the country go through the doors of VA facilities. We certainly want to leverage the spark we ignite with those trainees. Using health IT is a way to draw the best and the brightest into this field.”

Graham also is looking at using the data more wisely; finding different ways to not only present it to clinicians so that they are not overloaded. “In Health IT there’s a term of ‘alert overload’, says Graham. “We alert them about so many things that they become desensitized. We need to refine those alerts so they are personalized to the patient but also provide rapid relevant information to the provider at the time of care.”

“In the short run, I think what we are driving to is a functional interoperable health information system,” says Dell’s Max Peterson.

Peterson says one of the reasons why America’s health care system doesn’t rank as high in the world is because of that dis-aggregation of information and because of the extent to which the system has been a paper-driven, manual, individual and personal process with your providers.

“I think the opportunity there is to use health care, maybe build the Star Trek telecommunicator devices, but use the technology available today to get gains in productivity, gains in efficiency and quality. I think the successful solutions are going to be the ones that are simple, affordable, interoperable and secure.”

For Intel’s Jason Kimrey, the Star Trek future of a smart chip that a patient can swallow and it tells everything that needs to be taken care of may not be that far off.

“Those are the types of things that we are working on,” says Kimrey. “A lot of people don’t realize the transistors that we are manufacturing today are actually half the size of the influenza virus. So when you start thinking about concepts like molecular diagnosis, and lab ownership, the thing that you are describing actually isn’t that far off.”

Kimrey also realizes that technology can’t be imposed to solve a problem.

“Specifically in health care we’ve really had to relook at the way that we introduce technology. We really try to understand what are the problems people are facing in the health care industry today and how technology can solve them.”

For Unisys’s Patti Obermaier it’s all around patient empowerment; having the information and taking it where ever you want to go in the U.S. or abroad.

“I heard a term the other day called medical tourism, says Obermaier. “I had never heard that before, people go anywhere around the world and decide what they want.”

On a more personal level Obermaier says “I would just love to be able to stop having to fill out the same health records for my kids’ camps and schools. I want to have one system where I press a button and send it.

“But for us it’s all and having access to the information and deciding what we want to do with it. And who do we want to access it.”