At its most basic level, patient-centered care addresses the lack of information that hampers the ability of most clinicians to make the right decisions about their patients' care. It is based on the principle that sharing information – primarily clinical and administrative information – will dramatically improve the quality, access and affordability of health care.
Whether sponsored by the public or the private sector, the heart of each effort is an electronic medical record (EMR) – a secure, private, lifetime record of a patient's key health history and care, including diagnoses, imaging and lab test results, medications, etc. Unlike paper-based records, EMRs would be available electronically to authorized clinicians and patients anywhere, anytime. Why are we seeing progress now? Economic factors are among the most compelling drivers. In the U.S., for example, health care costs, which continue to grow at a rapid rate, account for more than 15 percent of the gross domestic product. Equally important are legal and regulatory drivers – such as HIPAA and the new Medicare drug law – which are helping to pave the way for health information exchange networks. In many other countries, legislation is creating a demand for patient-centered solutions.
Additionally, increasingly sophisticated consumers are voicing a preference for both higher standards of care and comprehensive treatment for the whole person, rather than procedure-by-procedure care.
At the same time, technology advances – including ASP architecture, voice recognition, wireless technology, public key encryption, virtual private networks and biometric identification – have made health information exchange possible and improved security dramatically.
The result: healthcare organizations worldwide are recognizing the limitations of data silos and are developing solutions to access and share clinical information. In Southwest Australia, for example, a statewide, patient-centered clinical information architecture has rolled out EMRs, a data warehousing system that allows physicians to conduct cross-patient analysis and a change management effort that encompasses online learning, classroom coaching and training materials. Today, several years after its launch, the system is serving more than 2.5 million patients, and the effort has reduced hospital stays by 10 to 20 percent, fostered better patient outcomes and improved staff and patient satisfaction.
More recently, the United Kingdom's National Health Service (NHS) has mandated the National Programme for Information Technology, which is creating the infrastructure, national applications and local systems to support the healthcare of every citizen. There, the NHS is designing, building and managing key information systems that include electronic appointment booking, transmission of prescriptions and patient records, as well as a national patient demographic service.Efforts such as these are proving the benefits of health information technology and data exchange. They provide decision support and administrative processes, such as management systems and hospital discharge pathways; help decrease unnecessary clinical testing and healthcare delivery; provide better medication management and help avoid drug-drug interactions; create databases of epidemiological information for public health officials; and enable automated filing and archiving of claims. By avoiding medical errors, improving the use of resources, accelerating the diffusion of knowledge, reducing variability in access to care and promoting public health and preparedness, we can improve patient care and reduce costs.
As with any transformational advance, we will have to address many challenges, including costs, evolving standards, the need for interoperability, reporting capabilities that address government and private requirements, varying levels of automation and integration – and the necessary changes in participating organizations.
But EMR's early lessons are clear: when health information is shared, the patient benefits. We believe that, with the right public and private sector programs and leaders, patient-centered healthcare can fulfill its promise of being essential healthcare.
Ken Lacey is the managing partner who leads Accenture's Health and Life Sciences practice.