My wish list for the healthcare industry

March 25, 2012

One doctor offers her professional wishlist for 2012. See what she hopes will happen this year.

1. Healthcare professionals, Americans, and government officials paying closer attention to Federal Health IT Strategic Plan. A revision of that plan may be in order.

The plan came out in November and was long overdue.

2. The emergence of more affordable solutions for healthcare systems and hospitals to attain meaningful use.

Once hospitals achieve meaningful use, they actually make use of patient information instead of merely passing it to the government. This ability promotes the design of more affordable solutions to healthcare that will be efficient and equitable. Recent studies already are demonstrating that using electronic health record (EHR) systems reduces variation in health disparities.

The very expensive, "fully integrated" EHR solutions on the market are not necessarily the best solution-or affordable ones at that-particularly for smaller hospitals and those located in rural areas. Other, more creative ways exist to solve these problems, and it would be nice to see companies start offering more of them.

3. Real interoperability, not just "lip service" interoperability of healthcare information technology (HIT) systems.

We've been hearing that integration is possible, but we're not seeing that happen. And it won't, unless large investment and effort is put forward.

The Health Information Technology for Economic and Clinical Health Act gave those in the healthcare industry promise because we believed that a bucket of money would be available for health information exchanges and for helping us all get connected. The truth is, hospitals have nothing to gain to get connected to one another from a financial standpoint. And vendors sometimes have a selfish interest to not connect to systems from other vendors.

We need to encourage real interoperability that helps patients and physicians by making it economically possible, if not profitable, to do so. Interoperability can't exist with disparate systems.

It makes sense for the Kaiser Permanente organizations of the world to be connected, because they're also the insurers. For the rest of the healthcare systems out there, it's not so convenient to get connected and, in fact, would only cost hospitals more time and money to adopt. That said, it would be best if interoperability were funded by the government. That way, the whole system would be consistent, and all vendors would be encouraged to work in harmony with one another.

4. A better roadmap depicting how we will get to the end game of healthcare that is patient-centered, evidence-based, efficient, equitable, and prevention-oriented.

Because the Centers for Medicare and Medicaid Services (CMS) is the largest purchaser of healthcare in the United States and its policies are followed by some of the most commercial organizations, it is incumbent on the agency to propose a long-term strategy. The experiments with medical home, accountable care organizations, and hospital no-readmission are important, but they should be part of a comprehensive strategy. A connection between the federal health information technology (IT) strategic plan and payer strategy, including and especially CMS, is needed.