Sunday, June 3, 2007

The Impact of Electrons

After working at developing a RHIO for three years, the complexities of this project impressed upon me the need for a compendium for physicians, providers and health IT personell. Anyone who is a provider, hospital administrator, claims manager and payor already know how complex the process has become to provide quality care and receive rewarding reimbursement.. I use the term “rewarding reimbursement” to differentiate making a profit that allows for capital investment and the ability to offer reasonable salaries and benefits to workers in the healthcare field. No one, physicians, hospitals, nor employees enjoys working 50-60 hour work weeks to be only able to skim along the bottom, or worse lose money.
We often hear or speak about quality assurance and improvement, measured by a variety of means and measures, some of which do not do either, but cost to develop numbers that payors would like to have and will be published on non credible public sites, such as the internet. We all know that statistics and studies can be misleading and misinterpreted, especially since demographics are vastly different for many hospitals and providers. Statistics emanating from UCLA and/or Cedar Sinai cannot be compared with a hospital in rural Blythe, Tehachapi or El Centro. There is now a “profit motive” for those who would publish these “statistics” for consumers to review.
A key concern for me is that much of the information being studied comes not from a clinical record, but from financial claims data. Assumptions based on this data to develop QA or pay for reporting is simply nonsense, as most physicians realize. Somehow or other we are not getting this message to the public, but consumer advocacy groups are moving forward with this concept of “infommercials”.
As I make my “rounds” discussing HIE and RHIOs I find most CEOs and even some CIOs eyes glaze over as I approach this topic. They are busy just “surviving”, trying to go faster and faster and cutting costs to survive. True visionaries that I meet are looking for a “solution” that IT will catalyze, not only in the adoption of IT, but redesigning the work flow of the practice and/or institution. The true power of the EMR and HIE lies in this overall process, not just the flow of electrons.
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