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 THE STAT 26Percentage of wireless customers who use their cell phones to take picturesMore Vitals
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JULY 7, 2004
A Paperless Health-Care System? [Page 2 of 2] MILITARY INITIATIVES. Middleton believes that better and broader use of IT could slice at least $130 billion off health-care costs annually. For many institutions, this will mean jump-starting IT investments that have lagged for decades. "Most of the nursing homes we work in don't even have Internet capability," explains Bob Chaput, IT director for Geriatrix, a Brentwood (Tenn.) company that sends nurse practitioners to convalescent homes to provide additional care for 2,000 institutional patients across three Southern states. Slowly that's starting to change -- and ironically, the U.S. government has led the charge. President George W. Bush has mandated that all medical record keeping at the Defense Dept. and the Veterans Administration shift to paperless systems, a process that should be close to completion in 2005. To make this happen, the military has launched a new series of tech initiatives. That includes the Central Credentials & Quality Assurance System, an electronic repository that stores and manages personal information covering the 140,000 employees in the military health-care network. "When a surgeon gets called up from reserves to go to Iraq, we can check right away what his readiness is," says U.S. Navy Captain Ben Long, program manager for the Resource Information Technology Program Office, the IT development arm for the U.S. military health system. NEW INCENTIVE. A far more ambitious Bush Administration goal is to move all health-care records in the U.S. into an electronic format by 2014. That might prove difficult, but an increasing number of private-sector health-care organizations have begun to plan for or install new IT systems. They've been spurred on by a growing number of insurance companies that are willing to pay a premium to providers that digitize large chunks of their records, which allows insurers to process claims far more easily. That's providing a new incentive for many hospitals and doctors to get with the IT program. In a February, 2003, survey of 287 health-care IT execs conducted by the Health Information Management & Systems Society, 68% of respondents said their operating budgets would increase in the next two years. The bulk of this money will go toward four big-ticket items: CPOE, electronic medical records, clinical information systems used to manage and standardize disease treatment, and bar-code management of medication and laboratory samples. While installing these systems is expensive -- ranging into the millions and tens of millions of dollars -- the results are promising. An October, 2003, study by the General Accounting Office found that each of the 10 hospitals or health-care organizations it visited realized significant savings and improved patient care from advanced IT initiatives, with the annual savings ranging into millions of dollars. QUICKER INSIGHTS. The ultimate promise of a digitized health-care system is not only better efficiency but improved service. Consider Evanston Northwestern. When a doctor there noticed one of his post-operative patients had extremely weak blood pressure, he adjusted her medications and realized the trouble probably came from a pain killer called Dilauid. Because all the medical records were in digital form, the doctor was able to quickly search other patient records for similar adverse reactions. He found evidence that Dilaudid was responsible for other instances of this problem and helped the hospital adjust its dosage recommendations accordingly. That type of insight might never have come to light in the old days, says Neaman. What's more, it's only the beginning. Because it's easy for computers to strip personal information from electronic records, physicians, pharmaceutical companies, and researchers will gain an enormous body of information that will be ready to slice and dice. That could mean faster warnings about side-effects from new drugs. Or it could allow epidemiologists to more quickly spot cancer clusters among people living near an abandoned chemical dump. "It becomes essentially data heaven. You can find millions of people with specific symptoms and have the statistical power to determine what's happening," says Middleton of Partners Healthcare Systems. "A MATTER OF WILL." Of course, the new technology is only as good as the people using it. Neaman spent $5 million on staff training to prepare them for the transition to paperless records. And Evanston Northwestern required a minimum of 16 hours practice time before employees could go live on the new system. Still, while Evanston Northwestern is internally paperless, it resorts to printers when sending out bills and records to companies that can't accept them in electronic format. "That has been our one big disappointment," Neaman says. "But we are envisioning a day when we can have online verification of benefits in real time and send all bills electronically" he says. Now, Neaman says, the hospital wouldn't know how to go back to doing business the old way nor would it want to. He's betting that other health-care institutions will soon follow suit. "It's not a technology issue. It's more a matter of will," he says. That will has been a long time coming, but it finally appears to be gathering enough critical mass to propel the U.S. health-care system into the Information Age.
 By Alex Salkever, BusinessWeek Online Technology editor
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