Health IT

Apple technology brings to mind sleek, hip devices, maybe a miniature music player or a laptop thinner than your hand. Medical technology conjures up thoughts of scary-looking big imaging machines, or maybe computerized health records.

We all know Medicare has problems. What you may not know is that we really do know a fair amount about how to fix it—and part of the solution has to do with changing the kind of medicine we use to take care of our over-65 population.

If reforming the health care system is like making buttered toast, then health IT is like plugging in the toaster—it is necessary, but not an end in and of itself, according to CBO director Peter Orszag, and echoed by fellow panelists Sara Rosenbaum and Janet Wright at Friday’s Alliance for Health Reform event, “Health Information Technology and Its Future: More Than the Money.” The event examined where health

It's no secret that U.S. doctors haven't rushed pell-mell to ditch all their paperwork and adopt electronic medical records. As we've heard repeatedly, money, resistance to change, money, concerns about obsolescence, money, and unanswered questions about how the whole system will work ("interoperability," or how one system will "talk" to another) are among the barriers.

As the Wall Street Journal blog suggested in a recent post, combine prescription pads, publicity about drug errors, and doctors' notoriously sloppy handwriting, and you've got to wonder why e-prescribing hasn't taken off. In some places—we'll talk about the auto industry in a moment—e-prescribing is becoming increasingly common. Yet, electronic prescriptions remain the exception, not the rule.

We had hoped to see progress in the Senate this week on the Wired for Health Care Quality Act, which would have given a big boost to the growth of health IT. Just last week, a reported agreement between Senators Patrick Leahy and Edward Kennedy on protecting the privacy of electronic health records generated movement on the bill. But some senators apparently still needed some persuading.

"Patient-centered medicine" is one of the buzzwords in health these days, so it was refreshing to hear from patients who actually had a voice in finding that center. Four spoke at a panel this spring sponsored by the Institute for Healthcare Improvement. Four patients. Four very different experiences. All had some success in creating a more responsive health care system.

The Aspen Institute's Health Stewardship Project this week held one of those forums about the presidential candidates and their health reform plans that have been popping up around Washington, and we were glad they added their voice to the call for health reform that addresses not just health insurance but also cost, quality, preventive care etc.

Earlier this week we posted our interview about the future of health IT with Carol Diamond of the Markle Foundation. (Part one, and part two). Today we'd like to point you to The Hill 's interview with Health and Human Services Secretary Mike Leavitt on the same topic.

Yesterday we posted the first part of our conversation with Carol Diamond, M.D., M.P.H., the Managing Director of the Health Program at the Markle Foundation in New York. She spoke about the potential of health information technology to improve the quality and restrain the costs of our care, as well as the research benefits. Today, in the second and final installment, she discusses some of the barriers to bringing 21st century tools to a paper-based health system, and the path to overcome them.

Q: What are the challenges to a national health information technology system?

A: There can't be one information technology "system." We start with a vast, highly fragmented and very diverse health care delivery model that is not centrally controlled or run. The only practical way forward is to acknowledge existing networks, and let them grow incrementally under a basic, common sense set of policies and standards. That's how the Internet grew.

The health care sector has a set of unique challenges that need to be overcome—and some have nothing to do with technology.

The first critical challenge is trust. Without it, patients and physicians will not be willing to use new technologies due to fear of privacy breach or the misuse of personal health information.