The quiet digitizaton of American health care

The quiet digitizaton of American health care:

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This is a guest post by Matthew C. Douglass, cofounder of Practice Fusion

For far too long, American health care has been out of reach for many. It certainly doesn’t help that the technology is dangerously out of date.

Most people know the government has been involved in addressing healthcare inequality: Obamacare. The Patient Protection and Affordable Care Act (ACA) works to fix that inequality by requiring insurance companies to play by a new set of rules to open access to healthcare — leading to over 10 million newly insured Americans.

However, more patients can mean more burden on an already tangled system. An estimated 195,000 deaths occur each year due to preventable medical errors, like a doctor giving you the wrong medicine because they don’t know you have an allergy. As you may have suspected, the long rows of paper files in the back of your doctor’s office are not the most cutting-edge digital technology. Since the beginning of the digital information age, American health care has been a decade or more behind the rest of the economy.

Enter the stimulus plan, Obama’s 2009 American Recovery and Reinvestment Act (ARRA). As part of ARRA, $59 billion has been allocated to the use of electronic health record (EHR) systems. This ambitious, largely unreported effort is attempting to build the nation’s healthcare technology backbone through three stages of EHR “meaningful use”: basic adoption, connecting information between EHRs and public health databases, and augmenting the doctor’s ability to care for patients.

The program is nearly five years and $18 billion dollars in. Unlike HealthCare.gov, which cost under a half a billion to build, Meaningful Use has attracted little attention despite (or because of) its notable success so far. Before the passage of ARRA, around 7 percent of US physicians were using an EHR as part of their daily routine when seeing their patients. Now that we’ve reached the end of Stage 1 of Meaningful Use, more than 40 percent of US physicians are on an EHR.

Skepticism of the investment remains, particularly among newer customers. Physicians who are more experienced with an EHR often realize the benefit to their practices and their patients. EHRs haven’t solved everything yet, but as a young technology they have also had to focus on basic adoption and data input so far—opening future doors to data-driven care, alerts and decision support.

Implementing an EHR: It’s like a highway

The implementation of EHRs is not unlike the Interstate Highway System. Both are big breakthroughs that required federal investment and regulation to happen at a broad, nationwide scale with consistent standards. Just like cars had to precede roads and roads had to come before highways, the “vehicle” of EHR technology had to be built and standardized before highways for delivering patient information between them could be built. This technology is now being connected so medical information can seamlessly follow the patient’s entire journey through life, avoiding the kind of preventable errors and costly repeated tests that currently plague healthcare. For example, EHRs finally follow a standard format of storing clinical data and demographics, which now allows for a common file type (C-CDA) to be created that can easily share and translate this information from one system to another.

As a patient, you’ll also now be able to start sending messages to your medical provider online through upgraded EHR systems, using a secure federal standard called DIRECT messaging. This sort of flexible communication is one of those powerful trends in healthcare that we’ve only seen in boutique healthcare plans and concierge practices so far — One Medical, Kaiser Permanente, and so on. While these services can be exceptional, they are also closed off to most people outside of major metropolitan areas. But not anymore.

And the advancements in healthcare due to Meaningful Use won’t stop there. Patients will begin to get access to their up-to-date health records and better manage their health online (my company Practice Fusion has a tool of its own, Patient Fusion). The data that has been entered into EHR systems for years will begin to be used as a basis for creating tools to help the doctors make better health decisions on the fly, directly within their EHR workflow. Care will be better coordinated between patients using different EHR systems while providing real time information to bodies like the CDC for public health purposes. Quietly, a vast groundwork is rapidly being laid for a healthcare system free of paper charts and walls of filing cabinets.

As Practice Fusion’s technology co-founder, Matt created the SaaS technology framework that enables rapid development of the electronic health record’s nationwide platform, now used by over 100,000 medical professionals monthly. He has spoken on healthcare technology at SDForum, Health 2.0, MIT, Stanford, and Microsoft events.