The January Wagner-Commonwealth Health Dialogue titled “From Examining Room to Chat Room: Is Information Technology the Prescription for Better Health Care?" examined the growing use of information technology in health care across a spectrum from hospital-based clinical and administrative information systems to the provider-patient relationship, and the consumer use of the internet for health information.
The dialogue brought together some of the top experts in these areas:
Ann C. Sullivan, Senior Vice President and Chief Information Officer of Maimonides Medical Center in Brooklyn, which was named one of the most Influential IT Organizations in the United States by Advance Executives; Thomas Delbanco, M.D., Chief of the Division of General Medicine and Primary Care at Beth Israel Deaconess Medical Center; Mary Jo Deering, Deputy Director for Management and e-Health in the U.S. Department of Health and Human Services’ Office of Disease Prevention and Health Promotion; and Dr. George Anderson, MD who has had a 30-year career in health care information technology and who has served as President and Chief Executive Officer of Oceania, Inc., which developed software solutions for physicians and other healthcare providers.
Sullivan said Maimonides’ IT system, Eclipsys, is used by all parties in the hospital and has brought extraordinary efficiencies. They have seen a 68% decrease in medication processing time; 60% decrease in medication discrepancies; 20% overall decrease in duplication of ancillary orders; and 48% decrease in laboratory tests. These savings contributed to a 12.4% decrease in length of average stay and 8.7% decrease in re-admissions, and generated nearly $20 million in increased admissions. They also led to much better information at the point of care, better regulatory compliance and increased patient satisfaction.
While acknowledging that real progress has been made, Dr. Anderson challenged the notion that health care was in the middle of a “technological revolution.” “Off the shelf” solutions to health care IT needs are usually not available, medical software development is expensive and medical applications using products created for other purposes often do not work. “Yes, we are experiencing real change” he said. “But the transformation is slow and far from complete.”
Dr. Delbanco framed his analysis of IT usefulness in terms of how it helps in the doctor-patient relationship. He said IT has given doctors and patients the ability to easily “convene around a shared patient record.” This, combined with a streamlining of information flow to clinicians, administrators and clerks, helps keep the patient fully informed. He regrets that IT has brought about a loss of privacy of the medical record, but said that at this point, ‘there’s no going back.”
According to Dr. Deering, a Pew Internet and American Life Project survey found that 70% of those who search for health information on the internet said that information influenced their decision about treatment; 50% said it led them to ask a doctor new questions or get a second opinion; and 28% said it affected their decision about whether or not to visit a doctor.
The National Committee on Vital and Health Statistics has been pushing for the development of a National Health Information Infrastructure (NHII) in order to capitalize more fully on dramatic transformations in information and communication technologies to improve health on a national and global scale. Dr. Deering said the NHII should be a set of technologies, standards, applications, systems, values, and laws that support all facets of individual health, health care, and public health, and that connects distributed health information in the framework of a secure network with strict confidentiality protections. But, she said, to implement the NHII, strong federal leadership, increased health-related IT funding and laws that protect privacy and make health data gathering easier are needed.
Funded by a generous grant from The Commonwealth Fund, the Wagner-Commonwealth Dialogue Series creates opportunities to facilitate the timely translation of health services research findings –even work in progress –from the researcher to practitioner, policymaker and the informed public.