Brave New Information Highway

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Because of the inefficient nature of paper records in healthcare, many hospitals and facilities have turned to a computerized system as reform. David Snow, Chairman and CEO of Medco, spoke at a recent AEI event and discussed this topic. He listed three guidelines for reform:

• “Keep it simple. If you make it complicated, people don’t understand it. They will reject it;”

• “Change has to be evolutionary, not revolutionary. We will not get Big Bang for healthcare reform. We won’t—for two reasons: Big Bang gets everybody up against it all at the same time and they clock any meaningful reform. We’ve all seen that. But, equally important, meaningful healthcare reform requires that we take a long-term view. We build our solutions; it’s a building block approach. The foundational building block is a wired system. And I’m going to try to prove that to you today; ” and

• “Finally, I do believe meaningful healthcare reform comes from government and private sector working together and recognizing their roles. In my view—and there’s plenty of examples to show that this is true—the government has to create, I call it, guardrails on the highway, under which the private sector can perform. So they have to promulgate, they have to regulate, and when they do that, it’s amazing how the private sector comes in and does what they’re good at—which is to operate and to innovate. It is a partnership. It’s a very different partnership, its roles and responsibilities and having a wired system requires promulgation of something and we’ve had examples of that in the past that have led to great improvements in healthcare.”

Snow said, “These are my fundamental principles. They tie into overall healthcare reform, [and] they tie to health IT, as well.” He continued, “My view is once you create this foundational opportunity—wiring healthcare—we can get at the real waste in our healthcare system. What is the real waste? …how we manage chronic and complex disease… We need an evidence-based, protocol-driven approach to the practice of medicine…the data is crystal clear…we…see in the data [a] drastic difference in practice around the same disease for the same type of patient tied to the age of the physicians, tied to the training of the physician…and there’s no justification…we need to narrow this down and get practice to protocol. We have to be able to see it…and we can learn from that visibility…it improves the way we take care of patients over time.”

Snow argued “[W]ired health care is a central depository—a patient-centric view of everything that’s going on around a patient across the country. So it’s not converting records from paper to digital in a doc’s office: it’s the lab results, it’s the health plan results, it’s the PBM’s [Pharmacy Benefit Manager] results, it’s the hospital’s results, it’s the doctor’s results. All being organized around the patient so we know what the patient’s doing end to end…we can see how that patient is doing tied to compliance, how is that patient doing in his treatment relative to what’s considered national protocol, how do we close those gaps in care. That’s a very powerful concept that only is enabled through a wired health care system.”

Snow ended his slideshow with a quote by President Obama about turning the healthcare crisis into an opportunity: “The problems we face today are a direct consequence of actions that we failed to take yesterday. We will wield technology’s wonders to raise healthcare’s quality and lower its costs.”

Heather Latham is an intern at the American Journalism Center, a training program run by Accuracy in Media and Accuracy in Academia.