Thought Leaders

Since the 1999 publication of the Institute of Medicine's "To Err is Human: Building A Safer Health System," patient safety has become an industry buzzword and a critical area of focus for healthcare providers. This study shocked the industry with the reported large number of near misses and adverse events that threatened the health of patients nationwide. According to the report, errors result in the deaths of 44,000 to 98,000 hospitalized patients and greater than 1 million injuries per year in the United States.

We've all heard the mantra about how technology will transform the healthcare industry—it will revolutionize the way doctors practice medicine, improve the patient experience, and make payer-provider communications more transparent. The industry has developed some very impressive solutions to support the revolution, but technology doesn't do much if no one uses it, and before they can use it they have to locate the funds to buy it.

As was pointed out in the pages of this publication not too long ago (From the Editor, April 2007), many healthcare technology vendors claim their systems help facilitate interoperability. As a matter of fact, while at the HIMSS Annual Conference in February, I visited the Vendor Directory kiosk and conducted a keyword search on the term, which produced a list of more than 90 companies—about 10 percent of the exhibitors—asserting their systems provided interoperability.

Greater transparency across all stakeholders is necessary to transform our healthcare system. Providers need transparency around the rules by which they are paid so they can understand what influences their reimbursements. Payers need transparency into providers' clinical outcomes so they can pay providers appropriately. Patients need easy-to-understand, comparative provider data in order to decide to whom they should entrust their care.

The methodical switch from ICD-9-CM to ICD-10-CM will bring both challenges and rewards to healthcare.
Consumer-directed healthcare was launched several years ago based on the premise that providing consumers with financial incentives to select cost-effective health services would reduce the high costs and low quality that have become pervasive in the healthcare industry. This “incentive” was a dramatic shift of financial responsibility to the consumer in conjunction with the implementation of lower premium/ high deductible plans. The intent was to decrease excess healthcare expenditures while encouraging comparison shopping for necessary patient care.

Healthcare organizations share a common vision: Attain improved safety, efficiency and quality of patient care. The problem lies in what they don’t share—common application standards, system interoperability and a regulatory compliant and competitive environment conducive to partnership. These challenges have undermined previous collaborative efforts, including the past failures of Community Health Information Networks (CHINs) and other health information exchanges. Instead of working together as industry partners, the current landscape positions their organizations as competitors, greatly hindering the development of enterprise interoperability and, eventually, organizational sustainability.

Today, at most, 20 percent of physicians are using e-Prescribing in their practices. The potential positive impact of e-Prescribing on patient care in the healthcare industry has been understood for almost a decade, but is only just now beginning to catch on. In a world where most processes have become automated, why has it taken so long for this shift in the healthcare marketplace to occur?