Blogger Matthew Holt Delivers Keynote Address at MEDITECH's Annual CIO Workshop
(7/10/2007)

Throughout their lifetimes, patients may visit dozens of different caregivers, medical departments, and facilities in order to treat conditions as simple as the common cold, or as complicated as diabetes. Keeping track of this patient data spanning across the care community, and transmitting that data to where it is needed to expedite quality care is one of the most important challenges hospitals undertake today. At MEDITECH's recent CIO Technology Workshop, over 250 attendees discussed these issues as well as ways hospitals can effectively use I.T. to unite care providers throughout the care continuum, as they begin laying the groundwork for interoperability.

The Keynote Address, delivered by health care consultant and well-known blogger Matthew Holt, analyzed the history and evolution of the U.S. health care crisis over the last several decades, and how rapidly increasing consumer costs have put adequate care out of reach for many. According to Holt, there is no easy solution for the industry's problems, but a solid foundation of up-to-date technologies and better information for both doctors and patients can help introduce positive change to the U.S. health system, one facility at a time.

"During the past five to seven years, we've seen an incredible rise in the costs of health care, to the point where insurance premiums are clearly outpacing wages," he says. "It is becoming harder and harder for middle class patients. And consumer-driven health plans, which are gaining popularity, are no magic bullet. If people have a choice about paying for care at the point of service, many will end up forgoing care, even if it's something as necessary as maintenance drugs for diabetes or heart disease. That, of course, will lead to longer-term problems."

Without some form of universal health care legislation, Holt predicts the amount of insurance provided by employers will continue to decrease, and many more people will join the ranks of the uninsured. He points out that over any two-year period, one in four people will be uninsured for three months.

“This is not a conscious choice,” says Holt. “Nobody wants to be uninsured. Politicians are just beginning to deal with the magnitude of this issue. But how big does the number of uninsured have to become before our leaders make a serious effort to do something about it? 25%? 50%? It’s anyone’s guess.”

Disease Management Tools Give Hospitals a New Direction
Health care organizations may not have the power to grant health insurance to every American, but Holt believes they do have the power to increase care quality while significantly lowering costs. He suggests widespread use of improved care technologies, like disease management tools, which allow organizations to closely monitor patients with long-term illnesses like diabetes and heart disease, while reducing costs over the long-term.

"By providing a better means to monitor chronic illnesses, providers can help these patients to make better informed decisions, stay healthier longer, and stay out of the expensive emergency rooms," Holt says.

He also points out that patients are more likely to choose conservative, cost-efficient treatments when presented with good information. With more knowledge and more options before them, patients will naturally become smarter health care consumers.

"It may seem counterintuitive, but in many cases, the best way to fix a medical problem is also the cheapest way—especially long-term," Holt says.

One complication in consistently delivering good information to clinicians and patients is the fact that best practices are always changing. A procedure considered most likely to give the best outcome two years ago may no longer be the best option for today. But by using evidence-based medicine services such as those provided by Zynx Health, doctors can stay up-to-date with the latest research and make well-informed decisions, which Holt says is likely to result in better outcomes and lower costs.

“For example, stenting was, until recently, considered by far the best way to treat blocked arteries for heart patients,” Holt says. “Today, medication management has been shown to be a better option for many patients. If intervention is needed, even bypass surgery is more cost-effective, where stents are likely to only delay the procedure. This is the type of information doctors and patients need to have access to at the point-of-care, so together they can choose the most effective treatment options currently available.”

Holt also believes that to make great strides in quality care while lowering costs, automated information tools like EMRs and CPOE need to proliferate throughout the U.S. more rapidly than their current rate. “The U.S. is lagging behind many European nations when it comes to adopting these technologies,” he says. “Organizations need to be committed to providing these tools to their staff, and the staff needs to be committed to using it.”

Hope for Change?
Holt is optimistic that in the next five years, most hospitals will have the tools and understanding required to effectively distribute health care services in a cost-efficient manner. He fears, however, that the overall national will to provide that cost-effective care will be harder to cultivate than the technologies themselves.

"Real change in health care requires real political change, on the national level, to create the incentives that will initiate change within individual organizations. This is necessary to reduce practice variations and to ensure that as many patients as possible get the appropriate level of care," he says. "Maybe then we can have a quality health care system that's affordable and accessible, not just for some of us, but for all of us."

Check out Matthew Holt's health care blog at http://www.thehealthcareblog.com/.

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