An editorial in Wednesday’s Wall Street Journal by Drs. Jerome Groopman and Pamela Hartzband of Beth Israel Deaconess Medical Center in Boston, “Obama’s $80 Billion Exaggeration” rightfully questions the savings to be realized from electronic medical records. I agree. It is very hard to quantify the return on investment for computerized health data even though most of us who work in the industry believe it is the right thing to do. America already lags behind other industrialized nations in the use of information technology in healthcare. Further delay in moving from paper records just isn’t defensible in a country that prides itself in being a world leader. But the big savings to be achieved from electronic data and greater use of IT in healthcare won’t come from the record systems themselves, it will come from how technology transforms clinical workflow, collaboration, communication, and the ways we care for our patients.
At least a third of the demand for primary care services comes from people searching for information, needing reassurance, or having a simple question they want answered. Many more visits are generated by people who are instructed to get a simple follow-up after a prior visit to the doctor. Today, our health system provides few alternatives for this besides the traditional “office visit” which is an inherently resource-intensive, inefficient, and very expensive way to care for relatively simple medical issues. Huge savings could be realized if people had alternative avenues to the traditional “office visit” for these simple exchanges of information or services. As I first mentioned back in December, that’s exactly what is now available to residents in the state of Hawaii.
In January, a new service was launched for all residents in Hawaii that I believe will one day become an integral model for improving the cost, access, and quality of care around the world. It will also go a long way toward improving the satisfaction of both those receiving and providing care.
Heath insurer, HMSA, has teamed with American Well and Microsoft HealthVault to launch what is likely to be one of the world’s largest pilots for on-line care. Using this service, people can now access a physician from the comfort of their home or office. They can get answers on how to care for minor illnesses or injuries. They can share their health history and medical information, and have it reviewed by a medical expert. They can talk to a specialist. The solution provides access to a physician by telephone or computer including on-line video conferencing so both patient and doctor can see and hear each other. A full range of collaboration tools helps doctors share information, web resources, and other materials during patient encounters. The system also provides full documentation of each encounter and makes it available for future office or on-line visits. Perhaps most important of all is that people now have a service, fully endorsed by their health insurer, that provides compensation to doctors for providing on-line services.
To help medical providers and patients better understand this break-through on-line service, we’ve produced a video. You can watch it by clicking below. Although this particular service offering is only available to residents of Hawaii, anyone in the country can start using Microsoft HealthVault today.
I truly believe we are witnessing the beginning of an important, worldwide adjunct to the ways physicians have traditionally delivered care to their patients. If you are a patient or a provider, this is one wave you’ll want to catch.
Bill Crounse, MD Senior Director, Worldwide Health Microsoft Corporation
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Hard to quantify? Hardly. You can save up to 25% of office visits with health IT. I fact in this months Health Affairs there is a great article on the cost savings that happened at Kaiser Hawaii.
Actually this isn't new though since both Group Health over on the mainland right next door to Microsoft's main campus as well as Kaiser in Californnia (also the only hospitals to reach level 7 of the HIMSS ratign system) have been using online tools for at least the past four years to link patients to providers. Their EMR s linked to a portal that gives patients access to labs, their visits summaries, email to docs, appts, a great knowlege base etc.
In fact there is a great article inn this months Health Affairs about how Kaiser Hawaii (Aloha) cut the number of visits to family practice by 25%. Oddly some people suggested that this model wasn't sustainable outside of a closed system like Kaiser as they felt that providers would lose income!
They fail to see the tremendous potential for innovation and access that would develop. One of the biggest arguments over universal coverage has been concerns about access to primary care based on what has happened in Mass.. Now that we know you can cut the number of visits by 25% you suddenly have the capacity to cover everyone.
The ideas and values of consumer engagement, collaboration, relationship building will always trump competition, the outdated organizational models we have seen in both Healthcare and IT (monopolies like the AMA that block more cost effective solutions like NP's and PA's as well as those that focus on prevention like ND's).
So yeah! I think its great that there is now another private provider of the same services that millions of Kaiser members already have in WA, OR, CA, and Hawaii but it is hardly new.
Thanks for writing. When I said savings were hard to quantify, I was speaking of the EMR in isolation to the kinds of solutions and services we are talking about here. Yes, I know all about what is going on at KP, GHC, UPMC, etc. I have many friends and colleagues who practice in those organizations. In fact, I worked as an administrator and practiced at GHC for a few years during my career. For a long time, I have been pointing out that these organizations are leading the nation in the integrated use of eHealth solutions in clinical practice. What is new in Hawaii is bringing the benefits of eHealth services to all residents within a geography and the fact that a major Blues organization is behind the initiative.
Bill Crounse, MD