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'Integrated, Incremental' Strategy Needed to Advance Health IT, Group Says

MAY 27, 2005 -- Interest in improving the quality and safety of health care and moving forward with health information technology are at "an all-time high" but a well-integrated approach is needed to keep the momentum going, according to a new report from the eHealth Initiative.

The report, titled "Parallel Pathways for Quality Healthcare," outlines what the group describes as an "integrated, incremental" strategy to help create a safer and more efficient health care system.

Any incentive program focused on quality should also include some level of incentive to improve the quality of health information technology, the report notes. In addition, any financing or incentive program concerning "health IT" should help improve the quality, safety, and efficiency of health care and should provide incentives to allow health care computer systems to talk to one another, a process known as "interoperability."

President Bush has called for most Americans to have electronic medical records within the next decade and has created an office with the Department of Health and Human Services (HHS) to accomplish that goal. In addition, a federal task force is working with health care industry experts to develop a set of standards for interoperability, and federal agencies are awarding grants to promising "health IT" projects around the country.

"We are at a unique point in time, where public and private sector interests are at an all-time high in two key areas: improving the quality and safety of health care and moving forward on a health information technology agenda," Janet M. Marchibroda, chief executive officer of the eHealth Initiative and Foundation, said in a news release. "Approaching these two key issue areas in a siloed manner—without strong integration across both—will result in missed opportunities, unintended consequences and possibly reduced impact in both areas."

Another step that may help speed the use of health information technology around the country is a new national network of "quality improvement organizations" (QIOs) that will work with physicians to help them adopt electronic health records and other aspects of "health IT."

Under a new three-year contract with the Centers for Medicare and Medicaid Services, the QIOs will target the physician practices that often need the most help—smaller and medium-sized practices that make up the majority of primary care practices in America, according to the American Health Quality Association, which represents QIOs.

The organizations will assist the physicians and their practices in a variety of areas, such as tracking how often they provide preventative services or how certain treatments work, such as annual blood sugar testing helping manage diabetes.

The QIOs' work does not duplicate the systems or assistance from private computer firms, AHQA David Schulke said at a May 25 news conference to discuss ways to help communities adopt personal electronic health records.

Getting smaller physician practices to adopt electronic health records will be tough, said Dr. John Tooker, executive vice president and chief executive officer of the American College of Physicians. While electronic medical records help physicians provide better care and can reduce health care costs, "it is a challenge to communicate and get every practice to change," he said, noting that the cost and complexity of taking such a step often stops a practice from doing so.

Panelists at the forum said they did not expect the federal government to fund the shift from paper to electronic medical records. "We've got to able to pay for this ourselves," said John Glaser, vice president and chief information officer of Partners HealthCare.

Heavy federal funding may also bring unwanted interference from federal officials, said Francois deBrantes, program leader, Health Care Initiatives, for General Electric. "We're always nervous about too much federal involvement" because of the rules and regulations it brings, he said. "Once they do it we can't step back."

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