Health IT must evolve to keep up with new demands

May 1, 2010

Significant progress will need to be made with the sophistication of the electronic medical records now in use.

However, significant progress will need to be made with the technologic sophistication of many of the electronic medical record systems now in use or scheduled to launch in the next few years. For instance, most EMRs typically do not increase a provider's productivity. In fact, productivity often decreases as providers change their workflows.

Personal health records (PHRs), a tool to empower patients to manage diseases more effectively, have yet to reach meaningful numbers of patients and virtually none have proof of empowering patients to better manage their care. Health information exchanges intended to make clinical data more accessible do not successfully connect these various applications.

To meet the needs of the changing healthcare landscape, a new generation of health IT is required. The capabilities needed to leverage health IT tools-be they PHRs, EMRs or others-cannot be satisfied simply by collecting retrospective data elements, reflective of care that was delivered in the past.

Systems will need to have a data foundation that has rationalized multisource manifestations of a clinical event and then eliminated the duplicate data to arrive at a single summary that provides appropriate context. Once the rationalized data foundation is created, health IT tools must use algorithms to generate information that will empower the individual patient to better self-manage chronic disease with less need for clinician resources.

These algorithms will be derived from the evidence base, expert opinions and consensus opinions. They are essentially a series of if/then statements. The output from these if/then statements can be used by EMRs to support quality processes, more efficient use of limited clinical resources and improve patient outcomes. Clinical information from these systems can be aggregated and reused in database-driven comparative effectiveness research, which can help physicians choose the best therapies, and ideally, the best value.

Healthcare reform emphasizes the need to evolve health IT beyond the current vision of EMRs simply exchanging data with one another through health information exchanges. Health IT should not exist just to send a piece of clinical data from one physician to another or tell a physician that a lab result is abnormal.

Instead, health IT must guide physicians toward the best and most efficient care management. It must empower patients to carry out their care plans conveniently and appropriately, especially in chronic disease management programs.

Efficiencies gained by appropriate use of next-generation health IT must allow physicians and other providers to accomplish tasks for greater numbers of patients through automation of care management functions, such as disease management and utilization management. Through these types of strategies and infrastructures, the healthcare industry will be able to meet the expanding service demand while still improving quality and safety.

Charles Kennedy, MD, is WellPoint's vice president for health information technology.