RHetoric

The message is simple: you would ask your waiter a few questions about the menu; so why wouldn’t you ask your doctor a few questions about your care?

I was talking health reform with my primary care physician last week, and she made an interesting comment:  “One of my biggest frustrations with healthcare is that most of my patients just expect me to tell them what to do.”

Whoa - this was not a criticism of Medicare, or Obama, or insurers, or anyone else in the supply chain - it was directed at the patients themselves!

As patients, we tend to think of our primary care physicians as the managers of our care.  But in truth, they are simply contributors.  Our insurance companies, specialists, and even friends and family are all contributors.  This can be frustrating and even vexing, but it is a golden opportunity for health reformers, and for IT.

If IT can make medical information more accessible, portable, and personalized, perhaps we patients can be empowered to ask informed questions and contribute to decision-making about our care.  We have a long way to go.  But some of the emerging tools within Google Health and HealthVault are encouraging.

Even if a patient never maintains a personal health record, asking a few questions at the doctor’s office could vastly improve the quality of one’s care.

With all the stimulus money lining up to flow into healthcare to spur the adoption of electronic health records, people are starting to ask exactly what the Obama Administration means by “meaningful use” of EHR’s.

It’s an excellent question, because it gets to the heart of the real public policy challenge.  What is the point of spending all this money if it doesn’t improve quality?  We cannot measure success by counting the number of PC’s in a hospital; we have to measure it by the number of errors eliminated; the improvements in care, and the elmination of inefficiencies.

Dr. David Blumenthal, a health advisor to the Obama team and now the president’s lead on health IT, does an excellent job of setting this stage in the New England Journal of Medicine.  One item he vaguely touches on but is sure to be the next wave of health IT advocacy and lobbying in DC is the pressure to change the law.  I don’t think that’s such a bad idea - there is far too much focus on EHR technology and not enough on all the other IT innovations that are already radically improving healthcare.  With or without changes, it is good to know that people have their eye on the real prize:  improving the quality of care.

Two news stories on parallel tracks this week that, if we can get them to cross connect, will create some really powerful momentum behind health I.T…

The first is a report about the frightening slowdown in U.S. productivity growth - the key measure of a country’s average standard of living. We are at a point today where it will take 52 years for our standard of living to double. According to the report’s authors, nearly all economists agree that the only real way out of this economic mess in the long term is to get productivity growth back up in a big way. With bailouts causing the national debt to lurch above $10 trillion, stimulating productivity is the only real method to grow ourselves out of this mess (versus allowing it collapse upon us, thereby blowing up our currency).

The second is the news about Obama’s stimulus package, and his intensifying focus on our nation’s I.T. infrastructure. His plan will devote billions to upgrading and extending our nation’s broadband infrastructure, picking up hospitals and schools along the way. While some think of infrastructure as roads and bridges, there is growing consensus that investments in I.T. infrastructure can return more long term value for the economy and productivity.

The intersection of these two stories is where health I.T. should be jumping off the page. Of all the economic sectors to have huge untapped productivity gains, healthcare is it. Of all the sectors that have the potential to bankrupt our federal government, healthcare is at the top of the list. There simply couldn’t be a more urgent time to devote the smartest minds and federal resources to modernizing our healthcare system with I.T.