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Report from eHI: Zeroing in on Chronic Care

January 12, 2012
by David Raths
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Annual conference highlights policy organization’s new focus on cancer, heart disease, diabetes

Celebrating its 10th anniversary, the nonprofit eHealth Initiative opened its annual conference on Jan. 11 by announcing it plans to sharpen its focus. Jennifer Covich Bordenick, the group’s CEO, led off the meeting by saying the organization would work on bringing the promise of health IT to the plague of chronic disease. “We want to work with members to advocate for cost savings and improved outcomes linked to e-health tools,” she said.

Covich Bordenick then introduced an all-star cast of healthcare leaders in cardiology and cancer care to talk about the potential of e-health tools to address the huge challenges the country faces in reducing the cost and impact of chronic disease.

First, Carolyn Clancy, M.D., director of the Agency for Healthcare Research and Quality, said she was excited about the Initiative’s new focus, adding that it dovetails nicely with AHRQ’s goal of working on long-term and system-wide improvement of health care quality and effectiveness. AHRQ has invested more than $300 million in contracts and grants, with an emphasis on rural and underserved populations, and much of that involves the deployment of health IT tools.

Jack Lewin, CEO of the 34,000-member American College of Cardiology, noted that 800 cardiologists have attested to meaningful use so far. “I would like to see 8,000 next year. It’s not that difficult,” he said.

Lewin talked about both the progress made in the use of electronic health records and registries, as well as the gaps that still exist in care coordination. The number of cardiologists using secure e-mail to communicate with patients is increasing rapidly, he said. On the other hand, the tools currently available for care coordination and hand-offs leave a lot to be desired, he added. Within the cardiology field, there is an increasing focus on communication tools. “Three years ago we weren’t thinking about patient education as much,” Lewin said. “But we realized that if there is not a bond between physician and patient and if shared decision-making isn’t the norm, we won’t get the results we are looking for. Obviously we can be frustrated we are not where we need to be in terms of interoperability, but we have come a long way and the gains are accelerating.”

Len Litchtenfeld, M.D., deputy chief medical officer of the American Cancer Society, stressed that lifestyle changes and increased screening could cut cancer deaths by as much as 50 percent. But part of the challenge is reaching people in rural and underserved communities. “The reality is that health IT can help us get there,” he said. “But we have to figure out how to reach all the people in this country where they live and work, not just an audience of college-educated folks.”

During a panel discussion on coordinating care for cancer patients, Lynn Vogel, PhD, vice president and CIO of the M.D. Anderson Cancer Center in Houston, said his hospital’s portal has proven popular with both patients and their referring physicians. In the most recent quarter, the portal recorded 800,000 log-ins, an average of 16 per patient. There were 100,000 secure messages between patients and physicians. “If patients don’t have access to their personal data, they turn to the Internet for anything they can find,” Vogel said. “We don’t want that.”

Lynn Vogel