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Political Leaders Define The Focus

December 3, 2008
by Joe Bormel
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Political Leaders Define The Focus

Cost Control and Coverage Expansion are our HCIT Opportunities

As leaders in health care organizations, we’ve got a challenging burden in keeping up with what other important leaders are thinking and saying. We also have a responsibility to educate other around us, as well as translate appropriate recommendations into the relevant and proven HCIT methods, where they exist.

So, I was delighted to find

several great resources in today's (11/24/2008) WSJ, including leading industry CEOs and several anointed political leaders:


Audio of Rep Rahm Emmanuel, chief of staff for President-elect Obama:



“you never want a serious crisis to go to waste”
(miss oppty to do things you couldn’t do before)

- “green” defined as having both immediate and long term benefits

- Five fundamental reforms: Healthcare focus is cost control/coverage expansion


The Top Five Recommendations for Healthcare



Use the presidential office to drive home the prevention message. Make reducing the obesity epidemic the top priority for the new surgeon general and the Centers for Disease Control and Prevention, while addressing race-based health disparities in obesity and other health problems. (Especially see Max Baucus comments in the link, “problem of obesity … tepid”)


Reform malpractice, using the National Vaccine Injury Compensation Program as a model. Create an environment that protects patients while allowing physicians to practice in high-risk specialties without facing prohibitively expensive insurance premiums.


Change the reimbursement system to reward preventive care and evidence-based care, and extend government efforts to no longer reimburse inappropriate, unsafe or wasted care. Move Medicare to a pay-for-value model. Define and measure desirable outcomes for most common diseases. Include costs to government, private sector. Redistribute Medicare payments to favor physicians who perform well. To collect data, wire the nation’s hospitals and doctor’s offices, with government-set standards for interoperability.


Focus on primary care. Include registered nurses, nurse practitioners and allied professions, as well as M.D.s. Make sure there are enough professionals to support increased access to care.


Enact comprehensive health-care reform, including universal access to affordable, quality insurance plans for those not covered by employer-based programs. Require individuals to buy insurance.

What are our roles as HCIT-informed executives? Drawing from Rep Rahm Emmanuel, our role has two focuses: 1) cost control, and 2) coverage expansion. Certainly items 3, 4, and 5 of the “Top Five” are in our domain and are instrumental to cost and coverage.

Traditionally, cost control for HCIT has meant driving operational efficiencies in high value areas. Please see my

post on bottlenecks

for my on my thoughts there. Most of us deeply believe in analytics, that is improving our performance by better using existing data as an untapped treasure.

I think the topics of multiple bloggers here on

hospital closings is critical. As an industry, the time may be right (Rahm Emmanuel’s comment “

you never want a serious crisis to go to waste”) to start advocating for

sustainable funding models for coverage expansion with defensible cost structures.

There has a fundamental analytic component. The burden/opportunity lies with each hospital category (such as community hospital with exclusive coverage domain) to lead our industry in new ways.

(For old ways, see “When The Givers Just Can’t Keep Giving / Even Nonprofit Hospitals Have Sustainability Limits”)

What do you think? Are these the relevant roles the strategic-minded HCIT executives, CIOs, CNOs, CMOs, COOs and other CXOs should be driving?

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