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Live from HIMSS: Halverson's take on healthcare reform

April 6, 2009
by kate
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Just a few notes from this morning’s keynote address, given by George Halverson of Kaiser Permanente. While many attendees can’t relate to someone with the resources Halverson has at his fingertips, there was still a lot of interest in his take on the current climate.

Some of the points he made:

At $2.5 trillion, healthcare is the fastest growing segment of the U.S. economy. If costs continue to skyrocket, healthcare, he says, will be the crippling factor in keeping the economy from recovering.

A systemic approach that involves best practices and coordinated care between healthcare providers is needed in order to improve care. (I heard one attendee question how on earth people are going to establish best practices that are agreed upon)

The National Institutes of Health has established a goal of 90 percent of care based on scientific evidence by 2020. This, says Halverson, is shooting way too low.

In order to thrive, the healthcare IT industry needs data to be computerized, interactive, and constantly available.

Kaiser has implemented a system of e-visits, is sending lab results directly to patients, and is piloting in-home monitoring. (One attendee remarked, “With that budget, who wouldn’t be doing all that?”)

His most interesting point, in my opinion, was an anecdote that illustrated just how ineffective the current healthcare system is with regard to communicating information to patients. There’s an ad for an Alzheimer’s medication in which patients are warned that if they are taking the drug along with a heart medication, they need to speak to their physician. As Halverson pointed out, perhaps Alzheimer’s patients shouldn’t be relied upon to tell their physician what other medications they’re taking.

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Comments

Kate,
Thanks for blogging on this. See my comments on Mark's coverage regarding the wonderful utility of your work.

Regarding Halverson's comment that 90% is too low, I strongly agree with the sentiment. It lacks definition, however, in two ways. "Scientific evidence" informing decisions is limited. See Dr Harold Lehman's video grand rounds from last year on "lessons from ITP." For a large number of areas where we badly need scientific evidence, we will never have it because of the number-needed-to-treat and number-needed-to-convince analysis of the objective problem. Harold is a multiply-boarded professor at Johns Hopkins School of Public Health. Every week, he publishes videos on real-world informatics.  The treatment is rigorous and relevant.  And, most importantly, it's published.  Hooray for Hopkins, Lehman, and Steven Mandell, (Steve/Stephanie, were last night's recipient of the prestigious HCI Innovators Award.)

Soap box: To the best of my knowledge, at least in the past, I have not been able to obtain videos from presentations like Halversons. So, I can't tell whether George's treatment was balanced and carefully worded, or, shall we say, written for him by marketing. (Nothing wrong with that, of course if, however it's grounded in what's been established about EBM, GRADE, and CTSA work, also recognized by NIH, that would create more value for me.)

kate

Kate Huvane, Associate Editor of...