Many Washington, D.C. policymakers (including the presidential candidates) talk about the need for more health information technology.  Everyone seems to agree that health IT will improve quality and can help control costs.  For instance, RAND has estimated that greater use of health IT will yield an annual efficiency savings of $77 billion over 15 years. A study in JAMA showed that when doctors use computers to order medications, preventable errors drop by as much as 55 percent.  Another study in the Annals of Internal Medicine showed 12 to 20 percent improvements in compliance with physician guidelines and other benefits.  Despite all this agreement, we haven't quite figured out how to get from here to there. So we asked Carol Diamond, M.D., M.P.H., the Managing Director of the Health Program at the Markle Foundation in New York, to share her insight into how we can overcome the policy and technical challenges and bring 21st century tools to our paper-based health system.

Q: Health IT can be confusing. If you were at a cocktail party, how would you describe what you do?

A: Markle's work centers on the idea that emerging information and communications technologies can improve peoples' lives. That includes the health arena. We are working to accelerate the rate at which modern information technology enables consumers, and the health system that supports them, to improve health and health care.

Health lags behind other sectors in taking advantage of 21st century information tools. We know there are great benefits to modernizing the way health information is collected, shared, and analyzed. Our work takes on the challenges that have so far prevented the widespread adoption of these tools. When we can overcome these challenges, and accurate information is available to consumers and those who care for them, the result will be better and safer health care.

Q: What is Connecting for Health?

A: Connecting for Health (http://www.connectingforhealth.org/) is a public-private initiative established by Markle in 2002 that brings together a diverse group of health, policy, and technology leaders. Though each person brings a particular perspective, together, we share a single purpose: to improve health and health care for consumers by advancing use of health information technologies (HIT). Over the years, more than 100 organizations have been participating in Connecting for Health, including consumer groups, clinicians, hospitals, government entities, privacy advocates, technologists, and businesses. Together we have worked to address and define the issues that can accelerate the use of HIT.

Connecting for Health brings together leaders working toward making vital health information available when and where it's needed in a private and secure manner so the best possible care can be provided.

Connecting for Health is led and operated by the Markle Foundation and has received additional financial support from the Robert Wood Johnson Foundation. I've been honored to serve as Chair of Connecting for Health since 2002.

Q: Why is information technology so important to improving our health care system?

A: Despite unprecedented levels of health care spending and advances in medical technology, American health care remains inefficient and ineffective in many ways. National spending is 16 percent of GDP, which is much higher than other industrialized countries. But on the basis of quality, the United States is ranked #37 by the World Health Organization.. And according to the Institute of Medicine, almost 100,000 Americans die every year from medical errors in hospitals. That's the equivalent of a Boeing 747 crashing every two or three days.

We know, today, that technology can improve efficiency, quality, and safety. By improving communication and care coordination among providers, implementing tools that offer decision support for clinicians, and enabling patients to access their health information when needed, patient safety could be enhanced while waste and inefficiencies in the system could be reduced. To illustrate, RAND has measured that if most hospitals and doctors' offices adopted health IT, the potential efficiency savings for both inpatient and outpatient care could average over $77 billion per year.

Look around to other sectors from banking to travel services to e-commerce. They are "networked." By tapping into information networks, you can pay bills, book flights, pay a stranger on eBay, etc. The U.S. health care system has yet to be transformed in similar ways. We must figure out how to share health information according to the needs and wishes of each individual so that they can receive the best possible health care and, at the same time, take great care to protect their privacy and the security of their health information.

Q. Can you give a specific example of how technology would positively affect care?

A: There are many. The complex world of modern medicine has become nearly impossible to navigate without the assistance of electronic systems. Simple advances in our ability to manage medications could have a profound impact on quality and safety. For starters, simply having a complete and accurate accounting of medications that people are taking can be an enormous step forward in terms of avoiding dangerous drug interactions. Information—such as whether you are allergic to a medication—can save your life. If that information is available, it can help those who care for you give you safer, more effective treatment and care.

But it does not stop at improving care for individual patients. It's also about learning more quickly what works and what doesn't work for whole groups of patients. Compared to paper, electronic health information can radically accelerate our ability to understand in a timely way what treatments work best, and which may present unacceptable risks. It can help us monitor the spread of disease outbreaks that may represent pubic health concerns. Information is critical to improving quality and safety for many people.

Consumers also need access to this critical information. Never have people been more engaged in using information tools to understand their own health or the health of their loved ones. Once people have access to their own information, they can take advantage of new information services to help them better manage their own health and to become better partners in their health care with their physicians and other caregivers. While simply searching for information about health conditions is the most popular reason for people to use the Internet in health, other forms of social media and social networking are taking hold. These include online forums, blogs, and live chat rooms. In many online communities, consumers are sharing their own information about their diseases, treatments and health experiences. These new streams of data, innovative tools and patient communities pave the way for new patient roles in health care research, decision-making, and information sharing.

(Check back tomorrow as Dr. Diamond talks about the challenges—and the progress.)