Shortcut To Better Health Care Florida Times-Union

Brian Klepper

You've just changed health plans and your child's pediatrician isn't in the network.

So in the throes of an asthmatic episode, you take him to a new doctor's office. In the exam room, a nurse asks you to list his medications. Flustered, you recite the ones you remember. Then she enters his name into the computer.

Up come his drugs - there's one you missed - as well as all health information about him that's available in the computers of Northeast Florida's doctors' offices, hospitals, labs and diagnostic centers. With knowledge of the extra drug, the doctor takes a different course of action than she otherwise would have.

The doctor can check notes made by other physicians and immediately see previous test results and images. She needs to do some tests, but she does not need to redo others. Another doctor ordered those recently on him. This new physician can use that information.

This was better quality, safer care. It cost less money, it was faster and it was more convenient. Your doctor is working from complete information, so she can make the best decisions possible. You and your insurance company did not have to pay to get information that was already available.

State-of-the-science privacy and security protections are in place, so your information is available only to other clinicians, and only if you've given written permission.

The doctor writes her notes in your son's chart and, when they're completed, his test results are entered. This information is now also available to any clinician in the region who sees him.

In this new world, everyone on the network - physicians, nurses, hospitals, long-term care facilities, pharmacists, diagnostic centers and social workers - has access to at least a basic "electronic medical record."

What's more, when changes are made to your electronic medical chart (the one used by the clinicians), your "personal health record" (a "light" version for patients' use) will be automatically updated as well.

As we continue to move toward consumer-directed health plans with high deductibles, these new tools can help patients monitor and manage both the care and costs of their own health.

What we've just described is a vision that's becoming increasingly popular and powerful throughout health care. Nearly everyone in the industry recognizes that linking health care organizations and professionals through the Web can create tremendous quality, safety and cost improvements.

Implementing them will require the collaboration of health care's different players. But there is every reason to believe that, once available, they'll enhance the overall experience for everyone involved, making access to the delivery of quality care less stressful, less complicated and less expensive.

In government jargon, the organizations that facilitate the exchange of local health information are called RHIOs or Regional Health Information Organizations, and they're popping up all over the country.

A local family physician, William Carriere, has spearheaded the development of the Northeast Florida Regional Health Organization. Local physicians, hospitals and health plans have all expressed interest.

The design is more practical than most regional organizations we've seen. Carriere and the development team see it as a "community health care utility."

By this, they mean a nonprofit organization supported by the larger community (and potentially hosted by a neutral party, like a local university) that creates value by linking health care professionals and organizations, and by delivering information that supports better health care decision-making throughout the community.

It's critical for the regional organization to provide valuable services to the community, because that will allow it to achieve financial stability, independent of external funding from government or philanthropies.

These regional organizations are a profoundly new and important development. They deserve the strong support of the business community because they should streamline out-of-control health care costs.

But equally important, if employers - who pay about half the bills in health care - are actively engaged in a health care information network, then they can enforce the disciplines of transparency and accountability that can make health care stable and sustainable again.

In other words, employers are key to realizing the regional organizations' enormous potential, which are substantial cost savings and quality improvements.

In the next several weeks, the Northeast Florida Regional Health Organization will reach out to the region's key groups - patients, employers, physicians, hospitals, health plans and government.

This is one of those rare opportunities to dramatically improve health care for each group and for everyone who lives on the First Coast.

Brian Klepper is the president of the Atlantic Beach-based Center for Practical Health Reform, a nonpartisan national effort to re-establish stability and sustainability in American health care. Larry Giusti is senior vice president of Harden & Associates, and a benefits consultant to regional and national employers.

This story can be found on Jacksonville.com at http://www.jacksonville.com/tu-online/stories/072406/opl_3994903.shtml.

Shortcut To Better Health Care

Florida Times-Union

Monday, July 24, 2006