Healthcare IT Section

SPECIAL ADVERTISING SECTION // TECHNOLOGY

Health information technology is helping close healthcare’s quality, safety and cost gaps and putting an industry’s focus

back where it belongs: on the patient.

BY RAY VALEK

TRANSFORMING HEALTHCARE THROUGH IT

lying home to Chicago last winter, HIMSS President and CEO H. Stephen Lieber, CAE, began suffering abdominal pain. After his plane landed, he was driven to his doctor, who, after conducting a blood test, immediately transferred Lieber to the emergency room.

At the ER, the same blood test had to be repeated before emergency surgery was performed to remove his appendix. “They don’t have systems that talk to each other,” Lieber observes. “Repeating a blood test was a medical waste,” delaying Lieber’s surgery, increasing his discomfort and adding unnec-essary cost.

Multiply the cost of Lieber’s one unnecessarily repeated test exponentially, and you can begin to understand how a national network of health information enabled by technology can reduce waste and related spending while improving healthcare quality and safety.

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A Rand Corporation research report published in 2005 conservatively esti-mated that $77 billion per year could be saved if most hospitals and doctors’ offi ces adopted health information technology (IT). More importantly, imple-menting this technology has proved to reduce medical errors, Lieber says, and associated injuries and deaths. A new Society of Actuaries study released in August 2010 reports that 1.5 million medical errors each year in the U.S. can be identifi ed through insurance-

claims data alone, and suggests that the real number is much higher. Medi-cal errors cause about 200,000 deaths a year, according to an investigation by the Hearst Corporation.

Health IT Promises to Improve Medical Outcomes And Reduce ExpenseAs HIMSS celebrates its 50th anniversary this year, it is playing a leadership role in efforts to use health IT to help trans-form a healthcare industry with serious

quality, safety and cost problems. This technology—including electronic health records (EHRs), e-prescribing, clinical decision support, health information exchanges and more—can improve medical outcomes and reduce expenses by providing rapid access to patient and clinical data.

Evidence-Based Care Considerations Improve Care Quality ActiveHealth Management, a subsidiary of Aetna, Inc., analyzes medical data from health plans, pharmacy benefi t manag-ers, laboratories and other sources on 19 million Americans to whom it provides health management services today. These data power CareEngine®, the company’s clinical decision support capability, which “identifi es gaps between the care that individuals are actually receiving and the care they should be receiving as refl ected in the medical literature,” says Active-Health Management’s President and CEO, Gregory Steinberg, M.D.

CareEngine uses evidence-based care alerts called Care Considerations to com-municate with physicians and patients via secure online portals, EMRs (elec-tronic medical records), mail, fax and, in urgent situations, telephone. In 2009, 16 million individualized Care Consideration messages were communicated to phy-sicians and patients, closing discrepan-cies in care.

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Key Milestones in HIMSS’ 50-Year History

HIMSS is a cause-based, not-for-profi t organization exclusively focused on providing global leadership for the optimal use of information technology and management systems for the betterment of healthcare. www.himss.org

HMSS is founded as Hospital

Management Systems Society.

1961

First conference is held in

Baltimore, Maryland.

1962

First HIMSS

chapter is established in New York.

1968

HIMSS extends

membership to

information systems

professionals.

1987

HIMSS begins to

accept corporate members, in addition

to individual members.

2001

President George W. Bush sets

the goal of a national

health information

network in his State

of the Union address.

2004

The American Recovery

and Reinvestment

Act invests $21 billion

in health IT.

2009

HIMSS establishes its 50th chapter

in central Pennsylvania.

2010


NaviNet Provides “Unifi ed Patient Information Management”Aetna sends member Care Consid-erations to healthcare providers via NaviNet, the nation’s largest real-time healthcare communications network. Through NaviNet, hospitals and medi-cal groups can securely exchange patient information with health insurers, and healthcare technology and service providers. This centralized, real-time information facilitates proactive and cost-effi cient care, says NaviNet CEO Brad Waugh. “For the patient, this trans-lates into a smoother experience at the doctor’s offi ce—they have your medical history, your benefi ts information, your billing information and more. You don’t have to make multiple phone calls and send faxes to multiple providers to get your medical information to the right physicians,” he explains.

Waugh calls NaviNet’s service “uni-fi ed patient information management.”

It brings together separate pieces of information from health plans, patients, providers and others into one place to present a singular view of the patient.

“Healthcare today is where the fi nan-cial industry was decades ago,” Waugh continues. “There used to be disparate, unconnected fi nancial networks, but now you can securely process fi nancial transactions from anywhere in the world. This is what we predict will happen in healthcare. All stakeholders—providers, insurers, IT vendors and, most impor-tantly, patients—will be able to safely and

securely access and exchange meaning-ful patient data regardless of their loca-tion. This will dramatically improve the patient experience.”

Nemours—Embracing Digital Work FlowAt Nemours, a health system that pro-vides care to 250,000 children in four states, Chief Medical Information Offi cer Dr. David Milov and the Nemours Health Informatics team lead a successful effort to seamlessly disseminate health infor-mation throughout the organization.

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“ Doctors are being paid for what they do, as opposed to being paid to provide better quality. To make quality happen, you need tools that allow data to be analyzed and transformed into actionable information.”

Gregory Steinberg, M.D., President & CEO, ActiveHealth Management


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Nemours uses EMRs that are fully inte-grated between its inpatient and outpa-tient care facilities, operating rooms, and emergency and radiology departments. Its consumer Web site (www.kidshealth.org) is extraordinarily empowering for patients and parents, says Dr. Milov, because of its ability to link relevant con-tent to a specifi c health record. The EMRs that Nemours’ pediatricians use display links to supporting Web site con-tent, which doctors can then select and issue to families at the point of care to help them better understand their child’s

diagnosis. Purchased and rebranded by 40 pediatric hospitals across the coun-try, KidsHealth.org also benefi ts parents and children outside of the Nemours system. The most-visited pediatric Web site, KidsHealth recently celebrated its one-billionth visitor.

Dr. Milov emphasizes that Nemours “paid the price, culturally” for these achievements. “The economic costs are often cited as prohibitive, but the cul-tural change required to do digital work fl ow is equally challenging,” Dr. Milov points out.

Helping physicians overcome concerns about work fl ow disruption and see the value of EMRs was key to Nemours’ effort, he says. “If physicians view EMRs as merely a data entry tool and they never get data back, they’ll never improve; they’ll never get better at it, and never love it,” he explains. However, when doc-tors receive data back comparing their performance to that of their peers or to a standard, “they get very excited about EMRs. Doctors need to see the value of their laborious data entry activities. When they see that, they become believers.”

Hard Numbers Prove the PointWhile there is general agreement that health IT can improve healthcare quality, skeptics doubt that it can reduce costs.

ActiveHealth worked with a 40,000-member health plan in Cleveland to implement a randomized, controlled clinical trial—designed to produce the highest level of evidence—to measure whether Care Considerations would improve quality as measured by reduced hospitalizations, while simultaneously reducing costs. For one year, a study group of 20,000 members received Care Considerations; 20,000 members in a control group did not.

The American Journal of Managed Care published the study’s results: The study group receiving Care Considerations had a statistically signifi cant decrease in hos-pitalization rates and costs.

Later, the Journal of Health Economics published a verifi cation of the study’s results relating to costs, which reviewed data that showed charges were the same for both groups during one-year periods both before and after the study. However, during the study, the study group had 6% lower charges, which the article con-cluded was due to the Care Consider-ations. “There is objective information that says arming physicians with infor-mation about healthcare quality does actually translate into reduction of costs,” Dr. Steinberg emphasizes. “Doing the right thing not only improves care, but also lowers costs.”

Collaboration Leads To the “Right Answer”HIMSS’ Lieber says the encouraging links being made between higher quality

“ Healthcare today is where the fi nancial industry was decades ago. There used to be disparate, unconnected fi nancial networks, but now you can securely process fi nancial transactions from anywhere in the world. This is what we predict will happen in healthcare. All stakeholders—providers, insurers, IT vendors and, most importantly, patients—will be able to safely and securely access and exchange meaningful patient data regardless of their location. This will dramatically improve the patient experience.”

Brad Waugh, CEO,NaviNet


and lower costs are the product of col-laboration. “This has always been fun-damental to HIMSS—in everything we do, we involve all of the relevant stake-holders.” He says, for example, a room full of vendors will give you the vendors’ answer, while a room full of users will give you the users’ answer. “But if you get them together, and there’s back and forth that occurs, you’re more likely to come up with the right answer.”

Over the years, he has seen HIMSS grow from an organization primarily for individual management systems engi-neers into one in which individual and corporate members are focused on transforming healthcare through IT. He also has seen federal government sup-port increase: For example, a $21 billion investment in health IT was included in the American Reinvestment and Recov-ery Act of 2009.

ActiveHealth and IBM — Delivering CareEngine Through Cloud ComputingThis national commitment is spurring innovation, such as ActiveHealth’s part-nership with IBM. Its new Collaborative Care Solution combines information from EMRs, claims, medication and lab data with ActiveHealth’s CareEngine and delivers it through an IBM cloud comput-ing platform. The solution promises to help doctors make more complete and

accurate decisions about patient care, and reduce medical mistakes and unnec-essary, costly treatments.

Aligning Reimbursement With QualityDr. Steinberg sees health IT initiatives as essential steps toward better aligning reimbursement with quality. “Doctors are being paid for what they do, as opposed to being paid to provide better quality. To make quality happen, you need tools that allow data to be analyzed and trans-formed into actionable information.” ■

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WEB DIRECTORY

ActiveHealth Management /www.activehealth.net

NaviNet / www.navinet.net

Nemours / www.nemours.org


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