WASHINGTON – The use of healthcare IT can lower costs and also deliver better care, says 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.
James spoke June 5 at a meeting of the Center for Health Transformation in the nation’s capital.
According to James, the current U.S. healthcare system is ailing from:
• massive variations in practice
• high rates of inappropriate care
• unacceptable rates of preventable care-associated injury and death
• a striking inability to “do what we know works”
• huge amounts of waste and spiraling prices
The craft of medicine, passed on by mentors, is a major deterrent for change, James said. Current medical knowledge is growing exponentially, doubling every eight years. Doctors have always relied on their experience, and now that is not the most reliable method.
At Intermountain Healthcare, James has instituted a program that establishes baselines of care. As progress is made, physicians are trained each month on what is working to improve outcomes. Intermountain has been able to dramatically improve outcomes in diabetes care, labor and delivery, cardiac care and others, according to James.
The Intermountain System provides care to the major urban areas of Utah and is responsible for the majority of the care in the state. After implementing IT and a baseline performance standard, Utah’s healthcare mortality rates are among the lowest in the world, according to a World Health Organization report. Utah has also enjoyed no growth in healthcare spending, according to a Wells Fargo inflation summary for 1988 to 2006.
James calls the use of IT and baseline methods - “profession based.” He says it puts healthcare professionals back in control of care because together they form a team that contributes to higher outcomes.
Don Campbell, MD, director of clinical informatics for Sheridan Healthcare in Florida and a panelist at the meeting, said his experience has proven doctors are resistant to baseline measure. It will take more than forcing pay for performance to change doctors’ opinions about how to practice, Campbell said.
Arthur Garson, Jr., MD, Dean of the School of Medicine, University of Virginia, said doctors’ complaints about the use of IT and performance measurement are unjustified. Within six to 10 years, the change will take place anyway, Garson said.
“It’s time to mandate it. Enough of this,” Garson said. “We need to say, get over it. Just do it.”