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EMRs alone cannot reform healthcare, Connected Health chief warns

January 23, 2009 | Bernie Monegain, Editor

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BOSTON – Don't overemphasize traditional electronic medical records as the answer to transforming healthcare, cautions the head of the Center for Connected Health.

"While EMRs are a critically important technology to improve quality, they support current workflow and reimbursement models that are tragically flawed and provide no incentive to rein in costs," said Joseph C. Kvedar in a response to President Barack Obama's call for recommendations on healthcare reform.

The Center for Connected Health, a division of Partners HealthCare in Boston, convened in December one of many community health discussions across the country that the then-president-elect, his transition team and Secretary of Health and Human Services Nominee Tom Daschle promoted.

More than 30 people, including academic and business leaders, technologists, physicians, health insurers, patients and payers, participated in the online discussion to explore the opportunities and advantages that connected health, population management and participatory medicine can offer.

The center's final report, submitted to the Obama team, addressed how connected health and its core tools - physiologic monitoring presented to the patient in a meaningful way, and data-driven coaching to help individuals make positive lifestyle and health behavior changes - could play a critical role in transforming healthcare delivery, improving quality and expanding access to care.

"Among connected health advocates, there is a concern that disproportionate emphasis will be placed on increasing access to care through universal coverage and on traditional health information technology, or electronic medical records (EMRs)," Kvedar said.

"True healthcare reform will require a more patient-centered approach and a broader policy palette, including incentives for providers to adopt more population health management tools and for patients and consumers to take more ownership of their health," he added.

Recommendations submitted to Obama's Health Policy Team outlined opportunities to create a patient-centered care delivery system, true payment reform that features payment for quality and not units of service, and incentives for widespread adoption of population health management tools and strategies, including connected health technologies.

The Center for Connected Health is applying some of these principles in providing care to chronic disease patients, Kvedar noted. For example, one of the center's initiatives is the Connected Cardiac Care program, offered to heart failure patients at risk for frequent hospitalizations. Data from a pilot study showed that connected cardiac care could reduce re-hospitalizations by improving patients' understanding of their condition and providing nursing support and review of vital signs, such as heart rate and blood pressure, while the patient is at home.
 

Related Topics:
  • Barack Obama
  • Boston
  • Joseph C. Kvedar

Reader Comments (2)Login to Post a Comment

Carolyn H says: EMRs Alone Cannot Reform Healthcare
January 26, 2009 | 10:22AM GMT

Yes, it's true the switch from a paper-based practice to an electronic practice in an of itself is not a cost-saving proposition. But the EMR vendors are telling physicians to embrace workflow assessments and process redesign as part of the change. Even so, the vendors cannot customize the system AND take on process redesign without help. Workflow analysis and redesign has to be part of the incentive. Totally agree on the reimbursement process as part of the problem.

kcolwell says: EHRs
January 23, 2009 | 5:37PM GMT

Dr. Kvedar:
You got it right. Much as we can wish that HIT implementation would save $80 billion, it's only a total transformation of healthcare that will get us where we need to go. We all want to take advantage of the new Administrations willingness to improve healthcare and I appreciate the thoughful recommendations you made.

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