The United States spends more than any other nation on healthcare and has arguably one of the most computerized healthcare systems in the world, and yet it is one of the least efficient. Now that President Obama is pushing for the digitization of medical records, the challenge of overcoming the widespread variations in the way health care is delivered in our country is more apparent than ever before. There are proven models that should be examined closely as part of the process associated with the HIT incentives. These models, at medical systems such as Geisinger Health System, the Mayo Clinic and Intermountain Healthcare, where I work, have developed electronic medical record systems that have the potential to significantly transform healthcare.

 What these models share is a priority on standardization. The term “interoperability” is a buzzword in our industry, but it’s only a part of the EMR solution. With established standards of usable data in place, real knowledge and information can be aggregated, analyzed and shared. It is knowledge sharing of best practices – and the computerized protocols and procedures required to implement them – that has the potential to really increase healthcare value.

 Start with standards. Creating standards that can be implemented for HIT systems across the entire country is not as daunting as it sounds. With strong leadership by the federal government, it could be done. With a number of organizations already working on these standards, we just need to determine who’s in charge. Standards should be based on logic and what makes the most sense for our nation’s future, and not dictated solely by the vendor community or those of us vested in current information systems.

 At Intermountain, our system-wide EMRs service a large geographical area with a relatively small team. We standardized systems and processes across our diverse organization as a means of increasing operational effectiveness, and we make a conscious effort to do things the same way across all our 21 hospitals and 140 clinics we serve across Utah and Idaho.

 Realize that organizations will have to retool. It is a hard pill to swallow, but today’s current HIT systems do not currently allow for the appropriate level of data sharing required. They simply were not designed to do this.
But solutions can be built and some forward-looking organizations are coming close. U.S. healthcare can continue to run the railroad with different gauges of railway (which is what we are doing with IT), or we can set standards, certify those standards and begin the process of getting to where we need to be. Change is seldom easy and the right answer will take some time and money. But this too can be done.

 Measure twice, cut once.  This is a carpenter’s rule and a good one to guide the U.S. healthcare industry. Twenty billion dollars spent appropriately on HIT will greatly improve healthcare. IT alone will not pull the country out of the current healthcare challenges – but it cannot be solved without IT. In many major industries, IT actually improves efficiency, improves quality while also lowering costs. These same outcomes can be achieved in healthcare, but only with proper planning; basing the plans on existing, proven successes; implementing standards (data, terminology, and transaction); and ultimately building and purchasing systems to solve our healthcare problems.

Marc Probst is vice president and CIO at Intermountain Healthcare in Salt Lake City. He was recently named to the U.S. Government Accountability Office’s Healthcare Information Technology Policy Committee, which will make recommendations on creating a policy framework for the development and adoption of a nationwide healthcare information technology infrastructure.