Monday, January 5, 2009

Kibbe and Klepper Reboot America's Health IT Conversation Part 2: Beyond EHRs

see my new policy blog for updates

David C. Kibbe and Brian Klepper PhD continue their thought-provoking recommendations on the Health 2.0 blog.
In a January 5th posting entitled "Let's Reboot America's Health IT Conversation," Kibbe and Klepper state their belief " that most health care professionals are acutely aware that more health IT alone cannot resolve these problems. Despite billions of dollars in health IT investments by health care professionals and organizations, the gap between the health care we believe possible and the current system is widening. persists and is widening."

Kibbe and Klepper argue that we don't need simply more health health IT; instead, we need an array of specific health IT functions and capabilities that can facilitate better care at lower cost, and the adherence to evidence-based rules.

Here are some of the characteristics they ascribe to empowering health IT products:

These systems would focus on Decision Support

New new health IT would help patients, clinicians, managers and purchasers make the best possible clinical and administrative decisions. They would provide guidance with evidence-based approaches that can best mitigate health risks, create alerts and reminders, or help monitor adherence to care plans,.

These systems would untether patients with easily accessible personal health information

These systems would improve care by making summary personal health information available to providers and patients, increasingly independent of location and time.

These systems would empower patients through online linkages to clinicians, other care providers, and other patients

Particularly in the management of chronic illness, these systems would link patients with clinicians, will match problems with the most appropriate solutions, and will use social networking to increase access to patient- and condition-specific information, knowledge, and guidance.

These systems would support participatory medicine, enabling the Medical Home and web-based care

These systems would make data and accountability the routine by-product of the use of health IT

Health IT can help make all health care professionals and organizations - physicians, hospitals, other providers, health plans, drug firms, device firms - more accountable stewards for quality, safety and cost results, and for the engineering required for continuous improvement. Data aggregation and analysis systems would be central to the design of health car information systems and not an afterthought. Incentives would play a significant role here.

These systems would remove the complexity and cost associated with multi-payer claims administration

Kibbe and Klepper envision an all-payer clearinghouse for patient administrative and financial information that is standards- and web-based. As they write, "there also is no good reason why, in the era of PayPal, physicians and hospitals experience Days in Accounts Receivable of 36 and 55, respectively."

These systems would close the collaboration gap

These systems would bridge the gap between the various fragmented delivery and payment systems. As they write, "Clinicians, for example, diagnose disease and set up treatment plans but often are isolated from helping patients cope, manage, or adhere to these plans. Patients, once diagnosed, are motivated to manage their illnesses but often have few tools or methods to assist them. Purchasers and payers want to see clinicians use the most efficacious resources, but typically do not have a way to inform and reward evidence-based purchasing processes. In every case, health IT can facilitate a more collaborative experience that is tailored to the user's purpose, no matter what role that user plays in vast health care space."

The Health 2.0 blog has some of the most insightful perspectives on not just technology but our approach to informatics. Always worth a read. Bravo.