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NG was right! We need a clear HCIT vision or HealthCare costs will continue to rise

July 17, 2009
by Joe Bormel
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There's a must read in today's (7/17/2009) WSJ:





Budget Blow for Health Plan
Congress's Chief Fiscal Watchdog (CBO) Warns of Overhaul's Cost; Ammunition for Critics





http://online.wsj.com/article/SB124775966602252285.html






CBO's Elmendorf"We do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount," Douglas Elmendorf, director of the Congressional Budget Office, told the Senate Budget Committee. "On the contrary, the legislation significantly expands the federal responsibility for health-care costs," he added.




As usual, the Comments tab is as important as the article.




The premise stated is that the core healthcare problems and solution that preceed "the two main objectives (of policy) are:


-

expand access to health insurance, and



- curb runaway costs,


not just for the government, but the economy as a whole."






Going back to Neal Ganguly's "

What's a community hospital CIO to do?" post, the shared HCIT vision must clearly address costs. And must do so in a way that's both plausible and transparent for the CBO. For example, reducing non-value-add redundant procedures, and waste due to lack of care coordination.




Regular readers of these blogs understand, and have seen the data that indicate, we can reduce wasteful spending associated with poorly coordinated care.




See my

Leap of Faith post for a recent example that CMS agrees with, i.e. addressing readmissions will help control healthcare costs.




Similarly,

better communication between care providers and patients is another large HCIT opportunity. This translates into fewer duplicated services, which drives down the costs generated. This can be measured today and going forward with episode grouping of services.




Neal is right. We need to up our game in communicating a cogent, shared HCIT vision. Otherwise, the arguments laid out in the CBO analysis (today's WSJ article) will ultimately document how we failed to advocate for rational HCIT.


Topics

Comments

Thanks Joe - As you state, there are clear opportunities, and the incentives need to be aligned properly to support pursuit of the desired benefits. Otherwise, we will waste a great deal of time and effort in trying to change behavior (independent of technology to some degree) which will needlessly delay the societal benefits.

Thanks for your comment Neal.

My thinking is turning to George Armitage Miller's Law:


"In order to understand what another person is saying,
you must assume that it is true and
try to imagine what it could be true of."
- (G. Miller 1980, p. 46)



That is: Assume, not accept, just assume that the other person's words are true, and try to imagine what they could be true of.


If we apply Miller's law to the CBO studies that conclude care management enabled by HCIT would raise net costs, we arrive at the conclusion that meaningful use needs to be either evidence-based, or evidence-informed. That means modeling. More on that in my next post!

Joe Bormel

Healthcare IT Consutant

Joe Bormel

@jbormel

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