We've reached the tipping point for the U.S. health care system — costs, quality and access issues have to be addressed. It is not possible to make the progress we need without the effective implementation of diverse, sophisticated information technology. Indeed, the American Recovery and Reinvestment Act HITECH program recognized the need for this IT imperative. Meaningful use incentives, regional extension centers, state health information exchange grants, quality measures development and data exchange standards are all intended to establish the base of interoperable electronic health records that will serve as the foundation to address our care delivery challenges.
The country's movement to coordinated care and population health management requires more than information technology. Reimbursement strategies must move from incentives to increase volume to incentives that reward quality, efficiency, disease prevention and the management of care over a continuum. The business and clinical models of care must shift to enable care to span a continuum, team-based care and care that follows the evidence. Information technology serves to support the new reimbursement approaches and clinical and business models.
The broad adoption and meaningful use of the EHR is the first building block. In addition, health information exchanges, based on interoperability standards and strong privacy protections, can facilitate interconnectivity and data-sharing across care settings. An HIE liberates clinical information collected within disparate EHRs, enabling a holistic view of the patient and a coordinated approach to care.
This is critically important in caring for the growing population of individuals with chronic diseases. All members of the care team need access to information to coordinate care and to ensure that it is targeted to the most cost-effective setting and with the greatest chance for a positive outcome.
In addition to the exchange of data between EHRs, health care organizations must be able to manage populations. This requires information technology that ensures that providers know for which patients they are accountable, each patient's care plan, deviations from those plans and which members of the care team need to follow up to address the deviation. IT allows providers to collect and aggregate population data and to use that data proactively to identify and stratify patients into cohorts for specific interventions and management. Care management helps with the management of both individuals and the populations of individuals.
Business intelligence and analytics provide the care delivery organization with the ability to monitor its care performance and costs, reimbursement and quality of care, and assess the degree to which patients are managed and are achieving their health goals. These analytical tools also enable providers to assess the reimbursement implications of changes in quality scores and to predict individuals who may need special care.
IT systems are important contributors in engaging patients in their own care, enabling patients to comply better with treatment plans and enabling earlier interventions, when necessary. Personal health records and mobile access to health information and reminders all serve to help patients become active participants in their own care.
Recently, IT has been both praised and criticized for its role in helping to alleviate the ills of the health care system. Regardless of opinion, without a solid IT infrastructure and sophisticated clinical and administrative systems, the goal of a cost-effective, efficient health care system that delivers high-quality care simply isn't possible.
John Glaser, Ph.D., is CEO of Siemens Healthcare's health services business unit in Malvern, Pa.