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Transforming Health Care PDF

190 Pages·2011·5.62 MB·English
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Transforming Health Care Better Data for Better Care Written and compiled by the staf at Evolvent Technologies, Incorporated, Falls Church, Virginia. For more information about Evolvent capabilities and what Evolvent can do for you, contact us via e-mail at Transforming Health Care Better Data for Better Care © 2011 Evolvent Technologies, Incorporated All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without the prior written permission of the copyright holder, Evolvent Technologies, Incorporated, Falls Church, Virginia. 050 EVO ISBN-978-0-9826568-1-5 Published by Evolvent Technologies, Incorporated 5111 Leesburg Pike, Suite 506 Falls Church, VA 22041 Printed in the United States of America Signature Book Printing, www.sbpbooks.com Dedication Te Evolvent Team is proud to dedicate Transforming Health Care to those we ultimately aim to serve: Our wounded warriors who deserve the best, smartest care we can give – supported by the most efcient, efective and data-rich technologies we can ofer; and, Our veterans of all times and ages who have borne the battle and who also deserve the same attention and care; and, Our ill and injured across this land who sufer, sometimes needlessly, and who so desperately need better data, richer information, and smarter care to return to health as fast as possible. Note: Any proceeds from this book will go to one of the following charity partners of Evolvent: Fisher Foundation OurMilitaryKids.org NIH Children’s Inn iii Table of Contents Foreword ....................................................................................................................ix Section 1 A Vision of the Future - Transforming Health Care (Introduction to Section 1) .......................................1 A Tale of Two Futures .............................................................................................11 Section 2 Key Enablers (Introduction to Section 2) ............................................................15 Security and Privacy as Enablers of Better Health Care .....................................17 Sustainable Health Information Exchange ...........................................................59 Health Care Financial Reform: Te Small Picture of the Health Care Financial Landscape ...............................73 Section 3 Transformation of Health Care (Introduction to Section 3) .............................85 Consumer Empowerment ......................................................................................87 Patient-Centered Medical Home ...........................................................................97 Telehealth................................................................................................................105 Health 2.0 and the Future of PHR .......................................................................115 Mobile Health Care ...............................................................................................129 Accelerating Clinical Research ............................................................................143 Clinical Decision Support ....................................................................................149 Aferword ...............................................................................................................155 Author’s Biographies .............................................................................................159 Glossary of Acronyms ...........................................................................................173 v Acknowledgements Each time we initiate a “book project,” it seems to draw out more talent across our organization. Tis project was no diferent. Many hands have contributed, and the ideas of all are brought together in the volume you see. Without all the eforts of our myriad contributors, this compendium of thought on how technology can help health care transform itself and deliver better care through the better delivery of information would not have been possible. My thanks frst to our core production team that kept this project on track. Mr. Greg Parish, Jr., again served as research manager, coordinator, analyst and writer, and did a magnifcent job. Greg’s intelligence, acumen and ability to synthesize ideas across the spectrum of all that is going on in health care today is remarkable and has made this book, I believe, an important work in our feld. Closely aligned with our writing team have been three individuals who kept this project moving and managed production activity on a very tight schedule – Ms. Jenn Cupka, Ms. Brittany Palmer, and Ms. Kari Larsen. Tese three kept us on track and made our ideas come to life in this fnished product! Tanks! Finally, joining our production team this year has been Ms. Stella Ramsaroop, who as production editor has really raised the bar in terms of the fnished quality of our manuscript. Stella’s professional capability as a journalist, her clear style and eye for quality communication have been of enormous help in improving our work. Tanks, Stella! And now, for the writers. I can hardly believe the talent and intelligence that we have assembled at Evolvent. Each of our leaders has contributed to this work and the combined power of this collaboration is clearly evident. Our primary writing team included J.D. Whitlock, Steve Gantz, Bill Sorrells, Geof Howard, Greg Parish, Jr, and Dave Parker. Contributing writers and reviewers included: Greg Parish, Jr., Monty Nanton, Kent Stevenson, Paul Ramsaroop, Joey Meneses, Dave Walton, Davis Foster, Anna Worrell and Anna Khizhnyak. My thanks to all of these talented professionals for their time and intellectual contributions. We are very proud to have all of them in the Evolvent corporate family. My continued and heartfelt thanks also to our client community for the opportunities we share to do good work. It has been an honor and a pleasure to work with our colleagues across federal health care for the last ten years and while much has changed and will change – the force we can be together for transforming health care is powerful indeed. Tere is also an unsung hero at Evolvent, who – like me – is deeply committed to our clients, employees and the future of health care – that is my vii partner of the last ten years, Paul Ramsaroop. Paul and I are proud of our team, but most gratifed by the diference we are all making. Finally, I would like to acknowledge and thank my family who gives me so much motivation, encouragement and conviction on a daily basis – making it clear how vitally important it is that we deliver better data to enable better care. viii Foreword Why this book and why now? Much has been said, written and continues to be written every day about the successes and more ofen – the failings of our health care system. For those of us who live in the world of health care and health IT every day, we are right at the focal point of a lot of national attention. And, rightly so. From a cost perspective, our health care system is fundamentally broken given its costs and our health care performance compared to many developed countries that spend signifcantly less. Tis conclusion has ofen been stated, sometimes aggressively, and has been a catalyst for much of the recent attempts at reform – yet we have not focused the debate on the results we seek as a society, just merely on payment methodologies and a few band-aids or attempts at moving to nebulous concepts such as “evidence-based” or “accountable care.” Te results I would suggest we seek are actually the improved delivery of care for all at a more reasonable share of national income. How much good conversation is actually occurring? How many good questions are being asked? How would we know? I ask this because it seems that in spite of all the national attention and the hyper-attentiveness of our nation’s leaders to health care and in particular, electronic patient record adoption – are we making much forward progress? In some cases, clearly the answers are a resounding “Yes!” Electronic record adoption is on the rise and certainly the incentives proposed by the Federal government over the last few years will probably only accelerate this trend. In other cases, we still see health IT systems that are arcane and proprietary and most importantly are fragmented within and across institutions. Most health care delivery organizations have hundreds of separate and disconnected technologies that do not share data even internally – let alone a full-fedged health information exchange (HIE) capability at a local, state, or national level. Why does this matter? If we seek to improve care, extend access to all, and do both of these in a more cost-efective manner – transformative change is required. Much of this change may be systemic in nature and beyond the scope of fairly apolitical health IT experts such as the authors of the book you are reading. Yet, we posit clearly in this work the following principles: ix

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