IT backbone will enable care in ways not yet imagined


Health IT will enable a sweeping transformation.

Keep in mind this dramatic change will need to follow some guideposts:

With those guideposts in mind, wiring our healthcare system creates a fundamental opportunity to attack waste. Part of the waste stems from drastic variances in practice when the disease and the type of patient are otherwise the same. A wired healthcare system would support an evidence-based, protocol-driven approach to medicine that points toward the best way to practice medicine.

If the entire healthcare system were wired, doctors could receive patient information at the point of service, which would allow doctors to compare their practice against peers and address patient issues directly. Taking this to the next level, a wired platform would enable payers to reimburse doctors for performance-finally providing the ability to value and compensate the physician's diagnosis, treatment and counseling skills, which are critical in raising the standards for quality care.


This new system would also make it possible to measure and monitor the effectiveness of care and use data mining to uncover dangerous trends.

For example, Medco's specialist pharmacists and its clinical staff took notice of a small study in France that suggested certain heartburn drugs potentially counteract the anticlotting effect of clopidogrel, a widely used blood thinner. Medco researchers conducted their own large-scale study by reviewing Medco's database of pharmacy and medical records and found that patients using proton-pump inhibitors in combination with clopidogrel increased the risk of a cardiovascular event by 50% overall.

As a result, the FDA issued a caution to all physicians about this interaction.

Healthcare IT presents a series of benefits that improve safety, raise the quality of care and reduce waste. It has the potential to leverage additional benefits in ways that no one can even imagine today, especially when computing power converges with the field of personalized medicine, largely driven by advances in genetics. Wiring healthcare is the first crucial step in that journey.

David B. Snow, Jr. is chairman and CEO of Medco Health Solutions, Inc.

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