WILMINGTON—Top Delaware officials on Thursday united behind a single idea in health care reform that they believe will have a huge payoff: coaxing the health care industry into the information technology age.
Delaware’s entire congressional delegation, along with Lt. Governor Matt Denn (D) and officials from Nemours/A.I duPont Hospital, appeared at the Alfred I. duPont Hospital for Children in Wilmington to advocate for the use of federal stimulus funds to expand the use of electronic health care records. The officials stressed that wider adoption and smart use of health information technology would both improve patient care and cut costs.
“There aren’t a lot of … very good ideas about how to contain health care costs,” noted Representative John Carney (D). “One very good idea is health information technology.”
“We spend way more money on health care in this country than any other country on earth. We don’t always get better outcomes,” said Senator Tom Carper (D). Noting that some doctors’ offices in Delaware already are harnessing information technology to improve patient care, Sen. Carper stressed that the same should be done “in doctor’s offices across the state and across the country. If we do that, at the end of the day we will get better outcomes and we’ll spend less money.”
Federal stimulus money is now available through the American Recovery and Reinvestment Act (ARRA) to assist health care providers with information technology (IT) expansion. The Medicare Electronic Records Incentive Program offers medical professionals and hospitals up to $44,000 over as many as five years for showing beneficial use of certified medical technology. The Medicaid Electronic Records Incentive Program offers up to $63,700 over six years. Delaware’s Division of Medicaid and Medicare has committed to participate in both programs and will be issuing incentive payments starting this June.
“There’s been a lot of talk about how health IT can reduce medical costs in the long run by reducing duplicative procedures and reducing unnecessary procedures, and that’s true,” said Lt. Governor Denn. “But to my mind the greatest benefit of health information technology is very simply is that it has the potential to dramatically increase the quality of care patients receive.”
When the incentive programs end, said Carper, providers who have not made progress toward upgrading their health IT will face small reductions in Medicare and Medicaid reimbursements.
“We have a lot of money to use for that ‘carrot’ [of financial incentives]. But eventually for those who don’t take advantage of that, there will be a little bit of a ‘stick’ as well,” Carper said. “I suppose there will be some hospitals, some doctor’s offices where a stick will be necessary, but I think that that will be the exception, not the rule.“
Nemours has been nationally recognized for its work in adopting health IT, earning a 2010 Nicolas E. Davies organizational award of excellence from Healthcare Information and Management Systems Society (HIMSS) for its work in the area. Nemours has spent $200 million over the last 15 years to build up its use of electronic health records.
Dr. Stephen Lawless, vice president of quality and safety for Nemours, says creating cutting-edge health IT is not just about capital investment. “You can’t just take an electronic medical record system, buy it from a store, load it into your computer, and say, ‘It’s there.’ That’s a big mistake. It makes you commit to 30 or 40 different measures of care”—measures that likely will improve outcomes, he noted.
Dr. Lawless credits electronic records with helping Nemours improve care in a number of areas, including reducing its wound infection rate, increasing the rate of on-time immunizations, and raising the rate of error-free medication administration to 99.98 percent.
Dr. David West, Nemours medical director of health informatics, notes that it is hard to quantify how much difference the use of health IT will make in other settings. But he believes easier access to records should be appealing to all medical professionals.
“All of a sudden it doesn’t matter if they are home, at a hotel across the country, or at a soccer game trying to address an acute situation that has come up. [They now have an] ease of access to the information to deal with that in a much more timely fashion rather than saying, ‘I have to go in the office on Monday to see what’s going on, and then I’ll call you.’ They can have it right now. That has been an absolute sell,” said Dr. West.
West believes cost has been a major hurdle for smaller health care providers in making the investment in health IT. He believes the incentive programs can potentially remove that hurdle.
“There’s a certain capital investment that’s required. You have to be an organization of a certain size at this point in time, and the stimulus package has been really helpful because it’s targeting the idea of making that cost barrier much less, so that the smaller practices that can’t have that economy of scale can start to participate and start to appreciate a lot of these benefits,” said West.
Senator Chris Coons conceded their has been some reasonable criticism regarding the use of stimulus money, but he points to these programs as examples where its use is working.
“Nineteen billion dollars of the American Recovery and Reinvestment Act was targeted at the implementation of electronic medical records. And through that we’re going to see over a number of years a fundamental transformation, I believe, in how health care is delivered,” Sen. Coons said.
