WASHINGTON – Healthcare IT adoption may be painful, but the fruits are well worth it, according to Brent James, MD, vice president of medical research and executive director of the Institute of Health Care Delivery Research at Intermountain Healthcare in Salt Lake City.
At a June 5 Center for Health Transformation meeting in Washington, James showed how Intermountain Healthcare is successfully lowering costs and improving care through the use of healthcare IT.
James has instituted a program that establishes baselines of care to measure performance. As progress is made, physicians are trained on a monthly basis as to what is working to improve outcomes.
Intermountain has been able to dramatically improve outcomes in diabetes care, labor and delivery, cardiac care and others, James said, and that has helped save money.
Intermountain provides care to the major urban areas of Utah and is responsible for the majority of the care in the state. Utah also has had no growth in healthcare spending, according to a Wells Fargo inflation summary for 1988 to 2006.
In addition, after implementing IT and baseline performance standards, Utah’s healthcare mortality rates are among the lowest in the world, according to a World Health Organization report.
Doctors don’t like the changes in workflow that instituting healthcare IT can cause, James said. “But in the end, HIT improves productivity, it doesn’t damage it,” he said.
Because of the use of electronic health records, Intermountain has been able to cut staff and save a substantial amount in transcription costs. The savings in time enables physicians to see one more patient per day, James said.
“Using the baselines has created a fundamental shift in how our providers see themselves,” James said. “I think the future is incredibly rosy. We are accelerating the rate of change and learning.”
However, merely sowing the knowledge of best practices doesn’t fundamentally change a healthcare system, James points out. It requires follow-through and some monetary incentives. It also requires support from the entire system to make it easy for doctors to “do it right.”
The practice of medicine has begun to intellectually agree with performance-based medicine, but it’s reaching the “heavy lifting phase” of making that happen, James said.
His prediction for the future? “Those doctors who are doing well will be OK. But those that aren’t will be chewed up. It’s a leadership challenge to bring all our colleagues along,” he said.