Obama plan for health reform includes evidence-based care

By Diana Manos
03:09 PM

President Barack Obama has laid out an ambitious plan for reforming America’s healthcare system that includes evidence-based care, an aspect of the plan embraced by both parties.

Regarding evidence-based care, or the practice of standardizing care to encompass only best practices based on outcomes, one doctor noted that today doctors either do what they’ve always done, with no evidence that it is the best practice, or they do what seems to be evidence-based, though there is no consensus. And if there ever were widespread consensus on care, how could it possibly be updated on a regular basis as the new evidence comes in? Who has the time to review the evidence?

The answer is simple. Evidence-based medicine cannot exist without healthcare IT. It is how results are measured. It is how knowledge is collected. It is “the meaningful use” that will create change.

Obama has recently held out such frontrunner organizations in evidence- based care as Intermountain Healthcare in Utah and the Geisinger Health System in rural Pennsylvania – both of which, he said, offer high-quality care at costs below average. At a recent conference held in Bethesda, Md. by the Agency for Healthcare Research and Quality, I discovered yet another – Trinity Health Systems in Novi, Mich.

Paul Conlon, senior vice president of clinical quality and patient safety at Trinity, said healthcare IT has enabled the system to transform care and thrive in the down economy.

Trinity began a project in 2003 to systematically install electronic health record systems in all of its 45 hospitals nationwide, with plans to invest $400 million over 10 years.

Though only 23 of the system’s 45 hospitals are up and running with healthcare IT so far, the return on investment is already beginning to show. This year Trinity Health Systems reported a positive margin, despite the recession and a 23 percent unemployment rate in some of its markets, Conlon said.

The project has required “going live” with IT overnight in each facility targeted for the change, but preparation takes up to two years in advance at each location, Conlon said.

The rewards? According to Conlon, there are plenty. Trinity now has 7 million patients with electronic medical records, the third largest repository in the nation.

Severity-adjusted mortality rates are at 70 percent, and 100 percent of the system’s core measure performance is greater than the national average. Nurses have 8 percent more time at the bedside and the IT has helped Trinity avoid some 14,000 potential adverse drug events per year.

Congress can lay down the money and mandate the transition to evidence-based care. But, Conlon said, “It takes people to change care, not just IT.”