Raising Healthcare Quality & Lowering Costs Through Health IT (12/08/2010 Press Conference)

>> GOOD MORNING, EVERYONE.
MY NAME IS DAVID BLUMENTHAL THE
NATIONAL COORDINATOR FOR HEALTH
INFORMATION TECHNOLOGY HERE IN
THE DEPARTMENT OF HEALTH AND
HUMAN SERVICES.
WANT TO WELCOME EVERYONE FROM
THE PUBLIC AND PRESS AS WELL
HATS OUR DISTINGUISHED PANEL IS
HERE TODAY FOR A VERY IMPORTANT
ANNOUNCEMENT ABOUT A NEW REPORT
ON HEALTH INFORMATION
TECHNOLOGY.
FIRST, I'D LIKE TO INTRODUCE,
IT'S A GREAT PRIVILEGE AND
PLEASURE TO DO SO MY BOSS, THE
SECRETARY OF HEALTH AND HUMAN
SERVICES, KATHLEEN SEBELIUS.
THROUGHOUT UNIQUE AND
CHALLENGING AND EXCITING TIME IN
THE HISTORY OF OUR HEALTH CARE
SYSTEM, SECRETARY SEBELIUS HAS
PROVIDED STEADY, WISE AND
COURAGEOUS LEADERSHIP OWN A WIDE
RANGE OF ISSUES THAT COME BEFORE
HER BUT MOST EXCEPTIONALLY ON
HEALTH CARE REFORM, ON REFORMING
OUR HEALTH CARE SYSTEM AND ALSO
ON ISSUE THAT MY GROUP, MY
AGENCY IS MOST CONCERNED WITH
THAT IS HEALTH INFORMATION
TECHNOLOGY.
AS INSURANCE COMMISSIONER AND
GOVERNOR OF KANSAS BEFORE COMING
HERE, SHE LEARNED HOW TO REACH
AND GUIDE CONSENSUS ON HIGHLY
CONTENTIOUS AND IMPORTANT
ISSUES.
AND THE ISSUES THAT WE WILL BE
DEALING WITH IN THE AREA OF
HEALTH INFORMATION TECHNOLOGY
CERTAINLY FIT THAT DESCRIPTION.
SO, IT'S A GREAT PRIVILEGE TO
HAVE HER AT THE HELM OF THE SHIP
DURING THESE EXCITING TIMES.
SECRETARY SEBELIUS.
[APPLAUSE]
>> GOOD MORNING, EVERYBODY.
AND THANK YOU, DAVID, NOT ONLY
FOR YOUR NICE INTRODUCTION BUT
FOR YOUR INCREDIBLE LEADERSHIP
OF THIS IMPORTANT PROJECT.
I JUST CAME FROM A DISCUSSION
WITH CEOs AT THE BUSINESS
ROUNDTABLE, I'LL TELL EVERYONE
ON THIS PANEL THAT THE NEW
REPORT OF REALIZING FULL
POTENTIAL OF HEALTH INFORMATION
TECHNOLOGY IS NEAR AND DEAR TO
THEIR HEARTS.
THE FIRST QUESTION I GOT ASKED,
HOW DOES THIS RELATE TO THE
MOMENTUM UNDERWAY FOR ELECTRONIC
HEALTH RECORDS AND HOW CAN WE
MAKE SURE THAT THAT IS ON TRACK
AS WE IMPLEMENT THE AFFORDABLE
CARE ACT.
SO THIS IS BEING WATCHED
CAREFULLY ACROSS THE COUNTRY.
I AM GLAD THAT ALL OF YOU ARE
JOINING US TODAY TO TALK ABOUT
THIS IMPORTANT NEW REPORT,
REALIZING THE FULL POTENTIAL OF
HEALTH INFORMATION TECHNOLOGY BY
P CAST, THE PRESIDENT'S COUNCIL
OF ADVISORS ON SCIENCE AND
TECHNOLOGY.
AND I WANT TO RECOGNIZE THE
LEADERS WHO ARE HERE WITH US
TODAY WHO DESERVE A LOT OF
CREDIT FOR PUSHING HEALTH I.T.
TO THE TOP OF THE NATIONAL
AGENDA WHERE IT NEEDS TO BE.
DR. ERIC LANDER IS HERE, PCAST
COCHAIR AND DR. CHRISTINE CASSEL
WHO LED THE WORKING GROUP ON
HEALTH INFORMATION TECHNOLOGY
AND IT'S NICE TO SEE CHRIS
AGAIN.
SHE AND I WORKED TOGETHER IN THE
'90s ON VARIOUS HEALTH ISSUES,
I KEPT TRACK OF HER BUT I DON'T
GET TO SEE HER NEARLY OFTEN
ENOUGH.
DR. DAVID BLUMENTHAL WHO IS OUR
BRILLIANT AND TIRELESS NATIONAL
COORDINATOR FOR HEALTH
INFORMATION TECHNOLOGY.
AND DR. LARRY SUMMERS WHO HAS
HELPED GUIDE OUR ECONOMY DURING
SOME OF THE MOST DIFFICULT TIMES
IN THE NATION'S HISTORY.
AND I ALSO WANT TO RECOGNIZE
at&t MOBILE HEALTH INDICISSER
PERMANENTE FOR ALSO JOINING US
TODAY.
THE ORGANIZATIONS HAVE BEEN REAL
HEALTH I.T. PARTNER AND
PIONEERS.
SO THE REPORT THAT PCAST IS
RELEASING TODAY SHOWS HUGE TO
HELP DOCTORS, EMPOWER PATIENTS,
REDUCE PAPERWORK, PROTECT
PRIVACY AND IMPROVE THE QUALITY
OF CARE.
IN INDUSTRY AFTER INDUSTRY,
WE'VE SEEN THE POWER OF
INFORMATION TECHNOLOGY BRING
DOWN COSTS AND IMPROVE CUSTOMER
EXPERIENCE.
NOW JOIN ME FOR JUST A MOMENT
AND IMAGINE GOING BACK TO THE
DAYS WHERE YOU WALKED IN TO A
GROCERY STORE AND THE CASHIER
WAS LOOKING AT HANDWRITTEN PRICE
TAGS AND PUNCHING THOSE IN, OR
WAITING FOR BANK TO OPEN EVERY
TIME YOU NEEDED CASH.
OR PAYING EVERY BILL WITH A
CHECK.
I DON'T THINK MOST AMERICANS
WOULD EVER ACCEPT THAT.
HEALTH CARE SHOULDN'T BE NOTICE
DIFFERENT.
AND IN FACT WHAT WE'VE SEEN IN
HOSPITALS AND DOCTOR'S OFFICES
ACROSS THE COUNTRY IS THAT WHEN
ELECTRONIC HEALTH RECORDS ARE
WELL DESIGNED AND IMPLEMENTED
CORRECTLY THEY ARE A POWERFUL
FORCE FOR REDUCING ERRORS,
LOWERING COSTS AND INCREASING
BOTH PROVIDER AND PATIENT
SATISFACTION.
AND I'VE HAD THE OPPORTUNITY IN
THIS ROLE AS SECRETARY TO VISIT
WITH HEALTH CARE PROVIDERS
ACROSS THE COUNTRY.
AND I STILL HAVEN'T MET A SINGLE
DOCTOR WHO SAYS, "I REALLY WANT
TO GO BACK TO THOSE DAYS WHERE I
HAD THOSE GREAT PAPER FILES."
THAT WAS REALLY THE WAY I LIKE
TO PRACTICE MEDICINE.
AND YET WHEN THIS ADMINISTRATION
CAME IN TO OFFICE TWO YEARS AGO,
JUST TWO IN TEN DOCTORS AND ONE
IN TEN HOSPITALS EVEN USED BASIC
ELECTRONIC HEALTH RECORD SYSTEM.
THAT'S BECAUSE EVEN WITH THE
BENEFITS OF EHRs THERE WERE
ALSO SOME VERY DAUNTING
OBSTACLES.
TAKES TIME TO LEARN A NEW
TECHNOLOGY.
ESPECIALLY IF YOU'RE A DOCTOR IN
A SMALL PRACTICE WITHOUT A
HEALTH I.T. STAFF.
THERE'S A CHALLENGE OF BEING
ABLE TO SHARE INFORMATION
SECURELY WITH OTHER PROVIDERS,
IF THEY HAVE A DIFFERENT SYSTEM.
AND THEN THERE'S THE FACT THAT
THE SYSTEMS CAN BE EXPENSIVE.
EVEN IF THEY PAY OFF IN THE LONG
RUN, THERE'S AN UP FRONT COST.
AND THAT'S WHY AS PART OF THE
RECOVERY ACT, THE PRESIDENT MADE
A COMMITMENT TO MAKE AN HISTORIC
INVESTMENT TO ELIMINATE SOME OF
THOSE BARRIERS.
WE'RE CREATING REGIONAL
EXTENSION CENTERS MODELED ON THE
OLD AGRICULTURAL EXTENSION
CENTERS, SO SMALLER PROVIDERS
AND SMALL HOSPITALS CAN GET
HANDS ON TECHNICAL SUPPORT
SETTING UP AND RUNNING THEIR OWN
I.T. SYSTEM.
PROVIDING GRANTS TO STATES TO
CREATE A FRAMEWORK FOR DOCTORS
AND HOSPITALS TO EXCHANGE
INFORMATION WITH FULL PROTECTION
AROUND PATIENT PRIVACY.
AND WE'RE INVESTING IN A NEW
HEALTH CARE I.T. WORKFORCE,
DOCTORS AND HOSPITALS WILL HAVE
STAFF TO HIRE WHEN THEY MAKE THE
SWITCH FROM PAPER TO DIGITAL
RECORDS.
THE CENTERPIECE OF THE PLAN IS A
PROGRAM THAT BEGINS IN JANUARY
WHERE DOCTORS AND HOSPITALS WILL
BEGIN TO GET INCENTIVE PAYMENTS
FOR ADOPTING ELECTRONIC HEALTH
RECORDS.
AS LONG AS THEY USE THOSE
RECORDS TO IMPROVE THE QUALITY
OF PATIENT CARE.
AT EVERY STEP ALONG THE WAY,
INSURING THE PRIVACY OF PERSONAL
HEALTH INFORMATION HAS BEEN OUR
TOP PRIORITY AND WILL CONTINUE
TO BE.
SO SINCE WE BEGAN TAKING THESE
STEPS WE'VE SEEN NEW MOMENTUM
BEHIND THE ELECTRONIC HEALTH
RECORD MOVEMENT.
IN THE PAST, SOME PROVIDERS HAVE
EXPRESSED SCWEP TAKE CIVIL ABOUT
THE STANDARDS THEY HAVE TO MEET
IN ORDER TO EARN THE INCENTIVE
PAYMENTS BUT IN THE LAST FEW
MONTHS, LEADING DOCTOR AND
HOSPITAL GROUPS HAVE COME OUT
SUPPORTING THE STANDARD AS THEY
HAVE BEEN ANNOUNCED.
WE WANT TO KEEP THAT MOMENTUM
GOING.
WHEN ELECTRONIC HEALTH RECORDS
ARE ADOPT DOCTORS WILL HAVE
BETTER INFORMATION AND MORE TIME
TO FOCUS ON PATIENTS.
PATIENTS WILL HAVE MORE CONTROL
OVER THEIR OWN HEALTH DATA,
EMPLOYERS WILL HAVE A HEALTHIER,
MORE PRODUCTIVE WORKFORCE AND A
STRONGER BOTTOM LINE.
AS THE REPORT WE'RE RELEASING
TODAY ALSO SHOWS, THERE WILL BE
MORE JOBS FOR AMERICANS AND ONE
OF THE KEY NEW INDUSTRIES OF THE
FUTURE THAT TECHNOLOGY OF HEALTH
INFORMATION.
SO, WE ARE ALREADY MAKING GREAT
PROGRESS BUT WE'VE GOT A LONG
WAY TO GO.
AND I WANT TO NOW ASK TO COME TO
THE PODIUM, LARRY SUMMERS, WHO
IS THE CHAIRMAN OF THE
PRESIDENT'S ECONOMIC COUNCIL TO
TALK MORE ABOUT THE REPORT.
DR. SUMMERS.
[APPLAUSE]
>> THANK YOU, MADAM SECRETARY.
AND THANK YOU FOR YOUR
EXTRAORDINARY LEADERSHIP THAT IS
THE REASON IN LARGE PART WHY ALL
AMERICANS ARE GOING TO HAVE
HEALTH CARE GOING FORWARD.
WE ARE VERY FORTUNATE TO HAVE
YOU IN THIS POSITION.
ONE OF THE GREAT STRENGTHS OF
OUR COUNTRY, A RESPECT TO WHICH
THE UNITED STATES STANDS OUT A
BIT RELATIVE TO OTHER COUNTRIES
AND IT'S SOMETHING THAT'S NOT
OFTEN HIGHLIGHTED IS THE
CAPACITY THAT EXISTS IN OUR
SYSTEM FOR COOPERATION BETWEEN
GOVERNMENT AND THE PRIVATE
SECTOR, BETWEEN GOVERNMENT, THE
PRIVATE SECTOR AND THE ACADEMIC
SECTOR.
FOR PEOPLE TO COME TOGETHER
ACROSS SECTORS TO COLLABORATE TO
SOLVE PROBLEMS.
CAPACITY OF AMERICANS TO FORM
ASSOCIATIONS AND THAT IS A
NATIONAL STRENGTH, SOMETHING
THAT WAS HIGHLIGHTED IN THE
1830s.
SO IT HAS BEEN SINCE.
THE KIND OF EFFORT THAT'S
DESCRIBED HERE NOT A TOP-DOWN
EFFORT FROM THE PUBLIC SECTOR,
NOT AN EFFORT TO IMPLEMENT A
FIXED PLAN, BUT ALSO NOT SIMPLY
A RELIANCE ON THE IDEA THAT ALL
GOOD THINGS WILL AUTOMATICALLY
HAPPEN WITH NO DIRECTION OR
GUIDANCE.
BUT A MIXED APPROACH IN WHICH
ALL THE STAKEHOLDERS COME
TOGETHER TO FIND SOLUTIONS FOR
EVERYBODY IS AN EXAMPLE OF WHAT
THE UNITED STATES DOES BEST,
WHAT WE NEED MUCH MORE OF.
I WANT TO MAKE THREE POINTS
TODAY.
FIRST, THIS IS GOOD JOBS AND
MACROECONOMIC POLICY.
YOU THINK ABOUT OUR ECONOMIC
SITUATION, WE'VE GOT EXCESS
CAPACITY IN MANY AREAS.
THERE ARE TOO MANY HOUSES THAT
HAVE ALREADY BEEN BUILT,
CAPACITY UTILIZATION IN
FACTORIES IS LOW, CONSUMERS ARE
OVER LEVERED, OTHER BORROWED
RELATIVE TO THEIR ASSETS.
WHERE CAN THE SPENDING POWER
THAT WE NEED TO ACCELERATE
RECOVERY COME FROM.
PART OF THE STORY IS DIRECT
GOVERNMENT ACTIONS AND THAT'S
WHY THE AGREEMENT REACHED A
COUPLE OF DAYS AGO ON TAX POLICY
IS SO PROFOUNDLY IMPORTANT.
PART OF THE ANSWER LIES IN THE
INTERNATIONAL SECTOR AND
EXPORTS, THAT'S WHY THE
PRESIDENT'S FREE TRADE AGREEMENT
WITH KOREA IS SO PROFOUNDLY
IMPORTANT AND MUCH ELSE THAT
WE'RE DOING TO PROMOTE EXPORTS.
AND PART OF IT IS IN INVESTMENT.
BUT AT A MOMENT WHEN THERE IS SO
MUCH EXCESS CAPACITY WE HAVE TO
DEFINE THE CATEGORIES OF
INVESTMENT A LITTLE BIT MORE
CAREFULLY.
FOR ONE REASON OR ANOTHER OUR
FAMILY HAS ACCUMULATED MORE
PCs THAN WE NEED AND THERE ARE
COUPLE OF THEM IN THE BASEMENT.
BUT WHEN THE iPAD CAME OUT I
STILL BOUGHT ONE.
WHY?
BECAUSE IT PROVIDED QUALITATIVE
IMPROVEMENT OF A KIND I SIMPLY
COULDN'T GET NO MATTER HOW MANY
REGULAR PCs I ATTACHED
TOGETHER.
IN THE SAME WAY QUALITATIVE
INVESTMENT THAT PROMOTES
TECHNOLOGY PASS TO BE AN
IMPORTANT PART OF OUR INVESTMENT
STRATEGY GOING FORWARD AS A
COUNTRY.
THAT'S WHY TECHNOLOGY IS SO
IMPORTANT.
NOT JUST ANY TECHNOLOGY, BUT
TECHNOLOGY THAT IS PERVASIVELY
APPLICABLE.
YOU LOOK AT THE ECONOMIC HISTORY
OF THE LAST 150 YEARS, IT'S A
LOT ABOUT THE STEAM ENGINE, A
LOT ABOUT ELECTRICITY, IT'S A
LOT ABOUT THINGS THAT CAME FROM
THE AUTOMOBILE.
ALL OF WHICH GAVE PEOPLE
CAPACITIES TO DO THINGS THEY
HADN'T DONE BEFORE AND TOUCHED
ALMOST EVERY ASPECT OF ECONOMIC
LIFE.
AND THIS GENERATION'S TECHNOLOGY
IS INFORMATION.
TECHNOLOGY WITH ALL THAT IT
MAKES POSSIBLE AND WE NEED TO
MAKE SURE THAT IT IS AN
EXPLOITED AS WIDELY AND
PERVASIVELY AS POSSIBLE.
AND WHAT BETTER TIME TO
ACCELERATE INVESTMENT IN
INFORMATION TECHNOLOGY THAN AT A
TIME OF SUBSTANTIALLY UNEMPLOYED
RESOURCES CAN BE PUT TO WORK
DOING -- PROVIDING JOBS THAT ARE
IMPORTANT IN THE SHORT RUN AND
PROVIDING CAPACITIES THAT ARE
PROFOUNDLY IMPORTANT IN THE LONG
RUN.
THAT'S WHY HEALTH INFORMATION
TECHNOLOGY WAS SO CRUCIAL A PART
OF THE RECOVERY ACT AND THIS IS
PROBABLY ONE OF THE LARGEST
EFFORTS GOVERNMENT HAS EVER
UNDERTAKEN TO SPUR INVESTMENT IN
A PARTICULAR CRUCIAL SUBSET.
SECOND, THIS IS ESSENTIAL AT
HEALTH POLICY.
I WOULD SUGGEST TO YOU THIS
PRINCIPLE: INFORMATION
TECHNOLOGY IN THE AMERICAN
HEALTH CARE SYSTEM SHOULD BE AS
PERVASIVE IN THE TREATMENT OF
PATIENTS AS IT IS IN THE BILLING
OF PATIENTS.
I CAN ASSURE YOU THAT
INFORMATION TECHNOLOGY PLAYS A
LARGER ROLE THAN IN 20% OF
DOCTOR'S OFFICES INVOLVED IN
BILLING AND I CAN ASSURE YOU
THAT IT IS FAR LARGER THAN 10%
OF HOSPITALS USE INFORMATION
TECHNOLOGY IN ASSURING THAT THEY
ARE COMPENSATED.
THERE IS NO GOOD REASON WHY THE
AVERAGE SEVEN-11 USES MORE
INFORMATION TECHNOLOGY THAN THE
AVERAGE DOCTOR'S OFFICE.
IT IS WRONG AND IT IS COSTLY.
IT IS COSTLY AT A TIME WHEN ONE
IN 20 PRESCRIPTIONS INVOLVE AN
ERROR.
IT IS WRONG AT A TIME WHEN TESTS
ARE DONE AND DONE AGAIN AND DONE
AGAIN BECAUSE IT'S NOT POSSIBLE
TO TRANSMIT THE RESULTS FROM ONE
DOCTOR'S OFFICE TO ANOTHER
DOCTOR'S OFFICE.
AND IT IS WRONG WHEN THE AVERAGE
MEDICARE PATIENT RECEIVES CARE
FROM SEVEN DIFFERENT PHYSICIANS
IN FOUR DIFFERENT ORGANIZATIONS
IN THE AVERAGE YEAR.
THIS IS NOT A PROBLEM THAT WILL
FIX ITSELF.
THE ESSENCE OF THIS PROBLEM
INVOLVES NETWORKS, YOU KNOW, THE
FIRST PERSON WHO GOT A FAX
MACHINE REALLY COULD DO VERY
LITTLE WITH IT.
THE SECOND PERSON WHO GOT A FAX
MACHINE ACTUALLY COULD DO MORE,
THEY COULD FAX TO THE FIRST
PERSON WHO HAD A FAX MACHINE.
BUT UNLESS THEY WERE MARRIED TO
EACH OTHER IT REALLY WASN'T VERY
EXCITING WHEN THERE WERE TWO FAX
MACHINES.
WHEN THE TECHNOLOGY SPREAD, THE
BENEFITS INCREASED FAR MORE THAN
PROPORTIONALLY.
BECAUSE NETWORKS WERE CENTRAL.
SO IT ALSO IS WITH HEALTH
INFORMATION TECHNOLOGY AND
THAT'S WHY GOVERNMENT NEEDS TO
GIVE THIS A BIG PUSH.
THAT'S WHY THE PRIVATE SECTOR
NEEDS TO COLLABORATE.
THAT'S WHY AT THE CENTER OF
ANYTHING THAT INVOLVES
CONNECTIVITY IS THE CAPACITY FOR
CONNECTIONS AND THAT'S WHY THE
ISSUES OF OPEN STANDARDS THAT
ARE STRESSED IN THIS REPORT ARE
SO PROFOUNDLY IMPORTANT.
THIS IS GOOD FOR THE ECONOMY.
THIS IS ESSENTIAL FOR THE HEALTH
CARE SYSTEM.
THERE'S A THIRD REASON WHY THIS
IS VERY IMPORTANT.
IT IS ESSENTIAL FOR PEOPLE AND
CAN CHANGE THEIR LIVES.
ACTUALLY CAN SAVE THEIR LIVES.
AS I WAS DRIVING OVER HERE, THIS
IS NOT IN MY WRITTEN TEXT, I WAS
REMINDED THAT JUST ABOUT 25
YEARS AGO I HAD IN A HOSPITAL
FOR SOME TIME WITH SOMETHING
FAIRLY SERIOUS AND THOUGHT THAT
I WAS LEAVING AT THE END OF THE
AFTERNOON.
AND AT 3:30 SOMEONE ARRIVED TO
TELL ME THAT ACTUALLY I WASN'T
LEAVING BECAUSE MY BLOOD COUNT
HAD DETERIORATED SHARPLY THEY
WERE GOING TO NEED TO EVALUATE
THE SITUATION THERE WAS LIKELY
TO BE A NEED FOR SEVERAL
TRANSFUSIONS AND THIS WAS A VERY
SERIOUS PROBLEM.
AS YOU CAN IMAGINE IT WAS A
RELATIVELY TRAUMATIC HOUR UNTIL
THEY ARRIVED SOMEWHAT SHEEPISHLY
AT 4:30 WITH COMBINATION OF GOOD
NEWS AND BAD NEWS.
THE GOOD NEWS WAS THAT I WAS
OKAY, THE BAD NEWS WAS THAT THEY
WERE A LITTLE EMBARRASSED THAT
THEY HAD A CERTAIN CONFUSION IN
READING A HANDWRITTEN RECORD IN
THE DISTINGUISHING BETWEEN WORD
SUMMERS AND THE WORD SIMMONS.
ALL THAT MEANT FOR ME WAS AN
HOUR'S TRAUMATIC AS ANY I HAVE
EVER SPENT.
ONE READS THAT FOR THOUSANDS OF
OTHER PEOPLE THE CONSEQUENCES
ARE VASTLY MORE SERIOUS THAN
THAT.
DON'T WE DESERVE TO DO BETTER
FOR AMERICANS.
LET'S NEVER FORGET AS WE TALK
ABOUT THE ECONOMICS, AS WE TALK
ABOUT THE EFFICIENCIES, AS WE
TALK ABOUT THE ISSUES FACING
DIFFERENT PROVIDERS THAT DOING
THIS FASTER AND BETTER IS ALSO
ABOUT LIFE AND DEATH FOR
THOUSANDS OF OUR FELLOW
CITIZENS.
THANK YOU VERY MUCH.
[APPLAUSE]
I SHOULD GIVE OUR NEXT GUEST THE
COURTESY OF AN INTRODUCTION.
PROFESSOR ERIC LANDER FROM MYTH
AND M.I.T. AND COLLEAGUE OF MINE
FROM THE BOSTON COMMUNITY AND
DISTINGUISHED LEADER IN MANY
RESPECTS BUT HERE ESPECIALLY IN
THE AREA OF BIOMEDICINE BUT HERE
TODAY AS THE COCHAIR OF THE
PRESIDENT'S COUNCIL OF ADVISORS
ON SCIENCE TECHNOLOGY, WELCOME,
ERIC, THANK YOU FOR BEING HERE.
>> THANK YOU VERY MUCH.
I AM HERE AS THE COCHAIR OF THE
PRESIDENT'S COUNCIL OF ADVISORS
ON SCIENCE AND TECHNOLOGY.
I'D LIKE TO SPECIFICALLY
ACKNOWLEDGE TWO OF MY COLLEAGUES
FROM PCAST WHO ARE HERE.
CHRISTINE CASSEL WHO IS SITTING
HERE AND CRAIG MUNDY WHO ABLEY
COCHAIRED THE WORKING GROUP THAT
STUDIED THIS PROBLEM OVER THE
COURSE OF ABOUT NINE MONTHS AND
BROUGHT BACK THE RESULTS OF THIS
TO PCAST.
I WANT TO THANK YOU BOTH FOR
YOUR EXTRAORDINARY SERVICE HERE.
AS HAS ALREADY BEEN SAID, THE
ADMINISTRATION IS DEEPLY
COMMITTED TO IMPROVING HEALTH
CARE FOR ALL AMERICANS.
THAT INVOLVES MULTIPLE THINGS,
ACCESS CLEARLY AN IMPORTANT
THING, BUT SO IS QUALITY AND
COST.
ONE VERY IMPORTANT COMPONENT AS
HAS ALREADY BEEN STATED IS
HEALTH INFORMATION TECHNOLOGY.
IT HAS THE POTENTIAL PERHAPS
MORE THAN ANY OTHER SINGLE THING
TO AFFECT BOTH QUALITY AND COST
IN THE RIGHT DIRECTIONS,
INCREASING QUALITY AND
DECREASING COSTS.
THERE'S A HUGE POTENTIAL, CHRIS
CASSEL WILL SAY MORE ABOUT IT TO
USE HEALTH INFORMATION
TECHNOLOGY TO INTEGRATE, FOR
EXAMPLE, PATIENT DATA SO YOU CAN
SEE A BIG PICTURE OF A PATIENT,
AVOID ERRORS, DETECT CHANGES IN
RECORDS BY COMPARING OVER TIME,
PROVIDE DECISION SUPPORT WITH
THE LATEST INFORMATION TO
DOCTORS.
BUT ALSO A LARGER LEVEL FOR THE
OVERALL HEALTH CARE SYSTEM TO
MAKE IT A LEARNING SYSTEM, ONE
THAT IS ABLE TO DISCOVER SIDE
EFFECTS EARLIER OR IDENTIFY WHAT
TREATMENTS ARE ESPECIALLY
EFFECTIVE FOR SUBSETS OF
PATIENTS.
BUT ALSO DRIVE DOWN COSTS
THROUGH MORE EFFICIENT BUSINESS
PROCESSES.
INFORMATION TECHNOLOGY HAS
INDEED TRANSFORMED SO MANY
SEGMENTS OF OUR ECONOMY,
PORTABLE PHONES AND WORD
PROCESSORS, THINGS WE DID BEFORE
IN LESS EFFICIENT WAYS AND
THINGS WE NEVER DID BEFORE,
SEARCHINGSEARCHING ALL OF THE
WORLD'S INFORMATION, FOR
EXAMPLE.
FOR SOCIAL NETWORKING ON A SCALE
NEVER BEFORE IMAGINABLE.
BY CONTRAST, HEALTH INFORMATION
TECHNOLOGY HAS LAGGED BEHIND
TREMENDOUSLY.
AS HAS BEEN ALLUDED TO MOST
POSITIONS -- PHYSICIANS DON'T
HAVE ACCESS TO OOP REALLY
MEANINGFUL DIGITAL ELECTRONIC
MEDICAL RECORDS.
THOSE WHO DO IT'S OFTEN RATHER
CUMBERSOME, NEVER TOLERATE IN A
WORD PROCESSOR, FOR EXAMPLE, IT
DOESN'T LET THEM INTEGRATE
THINGS.
SO AS AGAIN HAS BEEN NOTED THE
AMERICAN RECOVERY AND
REINVESTMENT ACT PROVIDED A
HISTORIC INVESTMENT IN INCENTIVE
PATIENTS TO PHYSICIANS AND TO
HOSPITALS TO ACQUIRE AND MAKE
MEANINGFUL USE OF HEALTH
INFORMATION TECHNOLOGY.
THE OFFERS OF THE NATIONAL
COORDINATOR OF HEALTH
INFORMATION TECHNOLOGY LED BY
DAVID BLUMENTHAL AND CMS HAVE
TOGETHER DEVELOPED MEANINGFUL
USE REGULATIONS AND STARTING IN
THIS COMING YEAR THESE INCENTIVE
PAYMENTS WILL BEGIN TO TRANSFORM
HEALTH INFORMATION TECHNOLOGY.
BUT AGAINST THIS BACKGROUND THE
PRESIDENT ASKED HIS COUNCIL OF
ADVISORS ABOUT A YEAR AGO TO
LOOK AT WHETHER WE THOUGHT THERE
WERE ANY ADDITIONAL COMPONENTS
THAT WERE NEEDED TO FULFILL THE
EXTRAORDINARY PROMISE.
WE IDENTIFIED ONE MAJOR ISSUE,
THE DATA THAT EXISTS IN THE
HEALTH INFORMATION SYSTEMS THAT
WE HAVE TODAY AND IN THE SYSTEMS
THAT WILL BE ACQUIRED BY
PHYSICIANS AND HOSPITALS WITH
THE FUNDING UNDER THE ERA
LEGISLATION, REALLY CONTAINS ITS
DATA IN COMPATIBLE PROPRIETARY
SYSTEMS WHERE IT'S VERY HARD
TINNED GREAT DATA ACROSS THOSE
SYSTEMS.
THAT'S A PROBLEM FOR THE PATIENT
BECAUSE THE PATIENT CAN'T OBTAIN
A COHERENT PICTURE OF ALL OF HIS
OR HER INFORMATION.
IT'S A PROBLEM FOR THE PATIENT'S
HEALTH CARE PROVIDERS.
IN ADDITION IT'S A PROBLEM
ECONOMICALLY, BECAUSE THE THIRD
PARTY INNOVATOR WHO IS THE HEART
OF I.T. INNOVATION, THE PEOPLE
WHO COMPETE TO WRITE THE BETTER
WORD PROCESSORS, THE BETTER
SEARCH ENGINES, WHEN THEY
CONFRONT THE MARKET THAT IS
FRAGMENTED IN TO HUNDREDS OF
SEPARATE INCOMPATIBLE PIECES,
THE INCENTIVES TO CREATE THE
TRULY INNOVATIVE TOOLS, ECONOMIC
INCENTIVES, ABILITY TO REAP THE
REWARD FOR INNOVATION ARE SO
MUCH BLUNTED.
NOW, OUR QUESTION WAS, COULD
THIS BE FUNDAMENTALLY SOLVED IN
A WAY THAT DID NOT REQUIRE
EVERYBODY TO START OVER, ONE
TEMPTING SOLUTION, JUST GET RID
OF EVERYTHING AND START OVER.
IT WAS GOING ON THE ASSUMPTION
THAT WAS NOT ACCEPTABLE
SOLUTION.
NOR WOULD IT BE ACCEPTABLE
SOLUTION TO SAY THE FEDERAL
GOVERNMENT SHOULD WRITE THE
SYSTEM FOR EVERYBODY, THERE ARE
A LOT OF GOOD REASONS WHY THAT
IS A TERRIBLE IDEA.
AND COULD IT BE DONE IN A WAY
THAT PROTECTS PATIENTS' PRIVACY,
THAT'S A VERY IMPORTANT THING
AND WAS CENTRAL TO OUR
DISCUSSIONS ALONG THE WAY.
SO PCAST THROUGH THE WORKING
GROUP CHAIRED BY CHRIS AND BY
CRAIG ASSEMBLED EXPERTS FROM ONE
THE COUNCIL AND FROM WITHOUT,
THE SHORT ANSWER TO THOSE
QUESTIONS WAS, YES.
IT TURNED OUT THAT THE KEY TO
REALLY BEING ABLE TO DO THIS IS
TO HAVE A CAPABILITY OF
UNIVERSAL EXCHANGE LANGUAGE.
YOU DON'T HAVE TO CHANGE YOUR
INDIVIDUAL SYSTEMS BUT IF THERE
IS A UNIVERSAL EXCHANGE LANGUAGE
TO WHICH ANY SYSTEM COULD WRITE
AND OUT OF WHICH ANY SYSTEM
COULD READ WE CAN GAIN MOST OF
THOSE BENEFITS.
AS TECHNICALLY POSSIBLE TO DO
IT, TURNS OUT, YES.
IT TURNS OUT THAT THERE ARE SAME
SORT OF TECHNICAL APPROACHES
THAT MAKE IT POSSIBLE FOR MANY
DIFFERENT BROWSERS, PROPRIETARY
BROWSERS TO ALL BROWSE WEBSITES
IN THEIR OWN WAY, BECAUSE
THERE'S UNIVERSAL EXCHANGE
LANGUAGE THAT MAKES IT POSSIBLE
TO UNDERSTAND WHAT THOSE
ELEMENTS ARE AND BRING THEM BACK
TOGETHER.
IT IS A SOLUTION THAT WORKS
ELSEWHERE.
YOU NEED TO HAVE A CERTAIN TYPE
OF APPROACH, WE REFER TO IT AS
MATE THAT DATA TAGGING APPROACH,
THAT WILL BE GEEKY, SOMEWHERE
DOWN THERE IT HAS TO BE GEEKY
STUFF TO MAKE IT WORK.
AND HAS TO BE INFRASTRUCTURE FOR
BEING ABLE TO ALLOW AUTHORIZED
USERS AND ONLY AUTHORIZED USERS
ACCESS TO THESE DATA TAGS IN AN
APPROPRIATE WAY.
WHAT IT DOESN'T REQUIRE, NUMBER
ONE, IT DOES NOT REQUIRE A
CENTRAL NATIONAL DATABASE OF
EVERYBODY'S HEALTH INFORMATION,
NOT A GOOD IDEA, DOESN'T REQUIRE
IT.
WHAT IT DOESN'T REQUIRE IS
NATIONAL PATIENT IDENTIFIERS TO
MAKE SUCH A SYSTEM WORK.
NOT NECESSARY, NOT EVEN A GOOD
IDEA.
WHAT IT DOESN'T REQUIRE IS FOR
EVERYONE TO DISCARD THEIR
EXISTING SYSTEM BUT BUILD LAYER
ON TOP OF THEIR SYSTEMS TO
TRANSLATE IN AND OUT AND OVER
TIME AS THE SYSTEMS ARE UPDATED
AND REVISED THE PROVIDERS OF
THOSE SYSTEMS CAN BUILD IN TO
RATHER THAN ON TOP OF THESE
TYPES OF STANDARDS.
WHAT ARE THE KIND OF FEATURES?
WELL, IT LET'S PRIVACY BE
PROTECTED IN VASTLY BETTER WAYS,
IT CAN BE PROTECTED AT WHATEVER
GRANULAR LEVEL YOU WANT.
YOU CAN WRAP PRIVACY NOT JUST
AROUND ENTIRE RECORD BUT
PARTICULAR ITEM WITHIN A RECORD.
THAT'S EXTREMELY IMPORTANT.
YOU WOULD BE ALSO ABLE TO MAKE
CHOICES ABOUT YOUR PRIVACY EARLY
AND HAVE THEM BEEN PERSISTENT.
IT PROVIDES A GREATER
FLEXIBILITY AND ARCHITECTURE FOR
PRIVACY TO BE EMBEDDED WITHIN
HEALTH CARE SYSTEMS.
AND WHAT IT DOES IS IT CAN
UNLEASH THE CREATIVITY OF THE
MARKET.
AND MARKET INNOVATION.
IT DOES REQUIRE SOMETHING TO,
GET THIS DONE THE FEDERAL
GOVERNMENT DOES HAVE A ROLE AS
LARRY SUMMERS SAID, THIS IS
REALLY ONE OF THESE GREAT
COLLABORATIONS THAT AMERICA IS
SO GOOD AT.
THE VAST MAJORITY OF THIS MUST
BE DONE IN THE PRIVATE SECTOR.
TO BE HAVE A COMMON UNIVERSAL
EXCHANGE LANGUAGE IT DOES
REQUIRE A COORDINATION, THAT IS
A CLASSIC ROLE FOR THE FEDERAL
GOVERNMENT IS TO BE ABLE TO
BRING TOGETHER INDUSTRIES TO
DEVELOP SUCH UNIVERSAL EXCHANGE
LANGUAGE AND OPEN STANDARDS IN
WAY THAT IS AVAILABLE TO ALL.
AND TO BE ABLE TO EMBED THIS
NOTION WITHIN THE MEANINGFUL
USE, REGULATIONS.
THIS SORT OF THING THAT FEDERAL
GOVERNMENT CAN DO THAT IS
CATALYTIC THAT IS NOT ENORMOUSLY
EXPENSIVE TO DO AND IT BENEFITS
ALL.
EVERYONE WOULD LIKE TO HAVE SUCH
A THING BUT NO ONE MARKET
INCUMBENT IS IN A POSITION TO
PROMULGATE SUCH A THING.
FEDERAL GOVERNMENT IS IN
POSITION TO BRING PEOPLE
TOGETHER TO DEVELOP SUCH A THING
THEN REAP THE MANY BENEFITS THAT
COME FROM IT IN PERFORMANCE AND
COMPETITION.
SO, IN CLOSING IN MANY, MANY
DIFFERENT WAYS IS CLEAR THAT
THIS ADMINISTRATION HAS FOCUSED
ON IMPROVING HEALTH CARE, THE
NOTION OF BETTER QUALITY AND
LOWER COSTS IS AT THE HEART OF
MANY OF THE HISTORIC
LEGISLATION, PIECES OF
LEGISLATION THAT HAVE PASSED
ALREADY, IT'S AT THE HEART OF
WHAT THE PRESIDENT'S COUNCIL
ADVISORS IS PROPOSING TODAY.
I WOULD LIKE TO NOW TURN TO MY
COLLEAGUE, CHRIS CASSEL, WHO IS
A PHYSICIAN AND IS IN POSITION
TO REALLY TALK ABOUT WHAT THESE
TYPES OF APPROACHES WOULD MEAN
FOR MEDICINE, FOR PHYSICIANS,
FOR HOSPITALS AND FOR PATIENTS.
THANKS VERY MUCH.
[APPLAUSE]
>> THANK YOU.
I WANT TO THANK MY PCAST
COLLEAGUE, SPECIFICALLY CRAIG
MUNDY AND DAVID BLUMENTHAL WITH
WHOM WE'VE WORKED VERY CLOSELY
AS WELL AS YOU CAN SEE THE
RECOMMENDATIONS THAT THIS REPORT
REALLY DO BUILD ON VERY
IMPORTANT GROUND BREAKING WORK
THAT HE AND HIS COLLEAGUES AT
ONC HAVE DONE.
BUT I THINK IT'S ALSO IMPORTANT
FOR US TO BE ABLE TO THINK ABOUT
HOW THIS STRATEGY AND VISION FOR
HEALTH INFORMATION TECHNOLOGY
REALLY CAN LEAPFROG IN TO A
FUTURE TO PROVIDE MUCH BETTER
PATIENT CARE TO, REDUCE THE
KINDS OF ERRORS THAT LARRY
SUMMERS TALKED ABOUT AND TO MAKE
HEALTH CARE PRACTICE MUCH MORE
AFFORDABLE AND MUCH MORE
EFFICIENT.
LET ME JUST OUTLINE FIVE
BENEFITS THAT I SEE FROM MY
PERSPECTIVE AND THAT ARE WRITTEN
IN THE REPORT AS WELL.
THE FIRST IS, REALTIME ACCESS.
REALTIME ACCESS TO COMPLETE
PATIENT DATA AND INFORMATION.
AND SUPPORT INFORMATION SUPPORT
FOR DOCTORS AND NURSES IN THEIR
DECISION MAKING.
SO IF YOU HAVE ALL OF THE
INFORMATION ON A GIVEN PATIENT
ACROSS TIME AS WELL AS ACROSS
MULTIPLE PROVIDERS AND MULTIPLE
ORGANIZATIONS IT WILL IMPROVE
THE PROCESS OF DIAGNOSIS, REDUCE
MISTAKES AND SAVE TIME.
BUT IT ALSO WILL ENABLE DOCTORS
TO ANALYZE DATA ON THEIR WHOLE
POPULATION OF PATIENTS THAT
THEY'RE TAKING CARE OF AND BE
ABLE TO THEMSELVES TELL HOW MANY
OF THEIR PATIENTS WITH
HYPERTENSION HAVE THEIR BLOOD
PRESSURE UNDER CONTROL OR HOW
MANY PATIENTS WITH DIABETES HAVE
THEIR BLOOD PRESSURE UNDER
CONTROL OR HOW MANY PATIENTS
WITH DIABETES HAVE BLOOD SUGAR
MEASUREMENTS WITHIN THE NORMAL
RANGE OR ARE GETTING THE
NECESSARY SCREENING TESTS.
CONSIDER THE FOLLOWING, FOR
EXAMPLE, USE CASE.
WE HAVE A ENOUGH OF USE CASES IN
THE REPORT THAT I URGE TO YOU
LOOK AT.
BUT LET'S IMAGINE 70-YEAR-OLD
WOMAN BEING TREATED FOR CANCER
WHO TRAVELS TO A REFERRAL CENTER
FOR MORE SPECIALIZED TREATMENT.
WHEN SHE GETS THERE, ALL OF HER
RECORDS ARE NOW INSTANTLY
AVAILABLE AVOIDING REPETITION OF
PAINFUL AND EXPENSIVE DIAGNOSTIC
TESTS.
AFTER SHE IS TREATED SHE TRAVELS
1200 MILES AWAY TO STAY WITH HER
DAUGHTER WHILE SHE RECOVERS.
BUT IN HER WEAKENED STATE SHE
FALLS AND BREAKS A HIP.
SHE GOES TO COMMUNITY HOSPITAL
EMERGENCY ROOM WHERE IMMEDIATELY
ALL THE RELEVANT INFORMATION IS
AVAILABLE TO THE TREATING STAFF
AND DRUGS THAT WOULD HAVE BEEN
DANGEROUS WITH HER RECENT
HISTORY ARE AVOIDED.
SHE RECOVERS AND RETURNS HOME,
THE INFORMATION FROM ALL OF THE
PLACES WHERE SHE HAS BEEN SEEN
ARE AVAILABLE RIGHT AWAY TO HER
PERSONAL PHYSICIAN.
HOW MANY AMERICANS TODAY CAN BE
CONFIDENT THAT THIS IS A STORY
THAT WOULD HAPPEN IF THEY OR
THEIR PARENT WERE IN SUCH A
SITUATION.
VERY FEW, ACTUALLY.
OUR VISION IS THIS BECOMES A
REALITY AND THIS BECOMES A
STANDARD OF CARE FOR EVERYONE.
THE SECOND BENEFIT, IMPROVED
CLINICAL PRACTICE WITH
INFORMATION TECHNOLOGY
INTEGRATED IN TO THE WORKFLOW
MINIMIZES UNPRODUCTIVE DATA
ENTRY WORK.
I HAVE TO TELL FROM YOU THE
PERSPECTIVE OF A PHYSICIAN,
THESE DAYS IT IS OFTEN VERY
CUMBERSOME AND COSTLY DEMANDING
THE PHYSICIAN'S TIME TO REPORT
QUALITY MEASURES FOR
ACCOUNTABILITY AND PAYMENT
PURPOSES WHICH ARE VERY
IMPORTANT.
A BETTER HEALTH CARE I.T.
STRATEGY COULD HELP REDUCE THIS
TIME AND COST AND ALLOW THE DATA
TO BE COLLECTED IN THE ACTUAL
PROCESS OF PATIENT CARE, NOT AS
AN ADD-ON PIECE OF WORK.
THESE DAYS MUCH OF THIS
INFORMATION IS PRODUCED FOR
INSURANCE PURPOSES, BUT IT'S NOT
TIMELY ENOUGH OR COMPLETE ENOUGH
TO REALLY DRIVE IMPROVED CARE.
YET MOST PHYSICIANS AND NURSES
ARE VERY INTERESTED IN
RESPONSIVE TO ACCURATE EVIDENCE.
HAVING QUALITY OF CARE PRODUCED
IN THE PROCESS OF PATIENT CARE
RATHER THAN AS ADDITIONAL DATA
ENTRY PROCESS, AND BEING ABLE IN
TO TEAR GAIT YOUR OWN DATA AND
ASK QUESTIONS ABOUT CERTAIN
KINDS OF DRUGS, THEIR EFFECTS,
CERTAIN KINDS OF TREATMENTS,
CERTAIN KINDS EVER PATIENT
CONDITIONS WILL LEAD TO
SIGNIFICANT HEALTH CARE
IMPROVEMENT.
THIRD BENEFIT, PATIENTS,
CONSUMERS, BECOME MORE INVOLVED
IN THEIR CARE AND ABLE TO TRACK
THEIR HEALTH DATA.
ACCESS TO BOTH THE INFORMATION
AND MULTIPLE INTERFACES, APPS IF
YOU WANT TO THINK ABOUT IT, WILL
MAKE IT EASY FOR PATIENTS TO
ACCESS INFORMATION FROM MULTIPLE
DIFFERENT SOURCES, PARTICIPATION
OF PATIENTS IN THEIR OWN HEALTH
CARE WILL SUBSTANTIALLY IMPROVE
NOT ONLY THEIR CARE BUT THEIR
CONFIDENCE IN THEIR CARE WHICH
IS ESPECIALLY IMPORTANT.
PARTICULARLY IN THE MANAGEMENT
OF CHRONIC CONDITIONS SUCH AS
HEART DISEASE, DIABETES AND
OTHERS.
CONSIDER THIS CASE, THIS USE
CASE.
A PATIENT WHO IS TAKING WAR IN
FROM, A BLOOD THINNER, OOP
TRAINS HIS CALF MUSSEL CAN'T
REMEMBER WHICH OF THE OVER THE
COUNTER MEDICINE THAT IS SAFE TO
TAKE GIVEN HE'S TAKING THE BLOOD
THINNER.
HE TYPES THE INFORMATION IN TO
HIS PENN HEALTH CARE LIST AND IT
GIVES HIM THE ANSWER TO THE
QUESTIONS.
INDEED, IT TURNS OUT THAT THERE
ARE CERTAIN PAIN PILLS THAT
SHOULD YOU TAKE AND CERTAIN ONES
THAT YOU SHOULDN'T TAKE.
HE E-MAILS THE PHYSICIAN THE
NEXT DAY, THOUGH, BECAUSE HE HAS
A BIG PAINFUL BRUISE APPEARING
ON HIS LEG.
HE SENDS ANOTHER E-MAIL TO HIS
PHYSICIAN'S OFFICE WHERE HE'S
CONNECTED TO THE NURSE THAT
MANAGES THE BLOOD COAGULATION
TEST.
HE ONLINE HE MAKES AN
APPOINTMENT COME IN AND SEE THE
DOCTOR WHO RESPONDS WITH THE
ELECTRONIC INFORMATION ABOUT THE
RESULTS OF THE TEST AND
MEDICATION ADJUSTMENTS HE NEEDS
TO MAKE BEFORE HE EVER EVEN SEES
THE PATIENT.
FOURTH BENEFIT.
PRIVACY AND SECURITY CAN BE
EMBEDDED IN TO THE MEANS OF
EXCHANGING DATA TO BE PERSISTENT
AND ACCURATE.
THIS APPROACH CAN IMPROVE
PRIVACY AND SECURITY AND
PATIENTS CONTROL OF THE DATA.
THE VERY SAME MECHANISM FOR
EXCHANGING CAN BE EMBEDDED WITH
THE NECESSARY SECURITY AND
PRIVACY PRECAUTIONS, ATTACHED AS
META DATA TO EVERY INDIVIDUAL
PIECE OF PATIENT CLINICAL DATA.
IT'S INSEPARABLE FROM THAT DATA.
ALL COMPUTER SOFTWARE THAT
TOUCHES THE DATA WILL BE LEGALLY
REQUIRED TO RESPECT THE PRIVACY
SPECIFICATIONS.
AND FIFTH, AND IMPORTANTLY,
HEALTH CARE RESEARCH WILL
IMPROVE BOTH IN TERMS OF PUBLIC
HEALTH MONITORING AND DRUG
TESTING AND CLINICAL TRIALS.
REALTIME DEIDENTIFIED DATA WILL
ALLOW MUCH FASTER, ALLOW EARLY
AWARENESS OF INFECTIOUS
EPIDEMICS AND OTHER THREATS TO
THE PUBLIC HEALTH.
THIS IS BENEFIT TO THE PUBLIC
THROUGH HHS AGENCIES LIKE THE
F.D.A. AND CDC AND STATE PUBLIC
HEALTH AUTHORITIES AS WELL.
AN EXAMPLE OF THIS WOULD ABILITY
OF EYESER PERMANENTE THAT WE'LL
HEAR FROM IN A MOMENT WITH THEIR
ELECTRONIC PATIENT RECORDS TO
IDENTIFY THE PROBLEMS WITH
CARDIAC SIDE EFFECTS, LONG
BEFORE THE MARKETPLACE STUDIES
REVEALED THIS.
ALSO CLINICAL RESEARCH BY NIH
AND ARC WILL BE ENHANCED AND
ACCELERATED.
BECAUSE ACCURATE PHYSICIAN ABOUT
PATIENT'S HEALTH CONDITIONS
COULD HELP SHOW WHICH PARTICULAR
GROUPS OF PARENTS ARE MORE
LIKELY TO BENEFIT FROM A NEW
TREATMENT WHICH COULD THEN
RAPIDLY ACCELERATE BOTH THE USE
OF NEW TREATMENTS BUT ALSO NOT
USING THEM WHEN THEY'RE NOT
APPROPRIATE.
SO, THESE FIVE AREAS REALLY ARE
WHERE WE NEED TO GO TO IMPROVE
CARE AND EFFICIENCY FOR OUR
HEALTH CARE SYSTEM AND THAT'S
WHAT OUR REPORT IS REALLY AIMING
FOR.
BETTER CARE, MORE PERSONALIZED
CARE, MORE EFFICIENT CARE AND
MORE GAINS IN HEALTH.
THESE ARE ALL PART OF THE
PROMISE OF 21ST CENTURY
INFORMATION TECHNOLOGY.
IT'S NOW MY PLEASURE TO TURN
THIS OVER TO TWO REPRESENTATIVES
OF MAJOR COMPANIES, BUSINESSES,
THAT HAVE USED AND INVESTED IN
THIS KIND OF RESEARCH.
ONE IN HEALTH CARE DELIVERY AND
HEALTH CARE DELIVERY SYSTEMS,
BERNARD TYSON EXECUTIVE VICE
PRESIDENT OF HEALTH PLAN AND
HOSPITAL OPERATIONS FARCIESER
PERMANENTE.
THIS IS WITH US TODAY.
ONE IN INFORMATION AND
COMMUNICATION, BILL ARCHER,
PRESIDENT OF ADVANCED SOLUTIONS
FOR at&t.
WILL ALSO JOIN US I'M GOING TO
CALL ON BERNARD FIRST.
SPBD
GOOD MORNING, IT'S
GREAT TO BE HERE ON TODAY TO
SPEAK ON THIS TOPIC ON BEHALF OF
KAISER PERMANENTE BUT ALSO ON
BEHALF OF A PERSONAL STORY.
I WAS THINKING AS WE WERE
TALKING THROUGH THIS THAT THIS
IS ABOUT THE FUTURE BUT IT'S
HERE NOW.
LET ME TELL YOU A LITTLE STORY
RIGHT QUICK IN SEPTEMBER OF 2006
I WAS HAVING FUN IN LAS VEGAS,
NOT THAT KIND -- AND ENDED UP
HAVING A HEART EPISODE THAT
LANDED ME IN THE EMERGENCY ROOM
AT ONE OF THE COMMUNITY
HOSPITALS IN WHICH I SUFFERED A
CARDIAC ATTACK.
I WAS PLACED IN AN INDUCED COMA,
I WAS TOLD LATER THAT THE
HOSPITAL CONTACTED THROUGH A
FRIEND WHO WAS TRAVELING WITH
ME, KAISER PERMANENTE, WHO IN
MATTER OF SECONDS WAS ABLE TO
DOWNLOAD ALL OF THE INFORMATION
THAT THEY HAD ON ME AND HAD TO
FAX IT TO THE HOSPITAL IN
LAS VEGAS.
FORTUNATELY THE INFORMATION WAS
READILY AVAILABLE, AND
FORTUNATELY WE DID HAVE FAX
MACHINES TO FAX IT.
THIS VISION WILL ELIMINATE THAT
STEP.
IT WILL TRANSFORM IT TO A WHOLE
OTHER LEVEL.
I WAS BROUGHT OUT OF THE COMA,
THEN I WAS TRANSFERRED TO MY
HOSPITAL IN SAN FRANCISCO AT
KAISER WHERE I UNDERWENT OPEN
HEART SURGERY.
I WENT BACK TO WORK IN JANUARY
OF 2007 AND AS OF TODAY I HAVE
NOT BEEN OUT ILL A SINGLE DAY.
BUT 90% OF MY CARE THAT I GET
FROM A QUALIFIED CARDIOLOGISTA
QUALIFIED NURSE AND COUPLE OF
OTHER TEAM GIVERS IS PROVIDED TO
ME VIA THE KAISER PERMANENTE
HEALTH SYSTEM.
I HAVE ALL THE INFORMATION MADE
AVAILABLE TO ME TO KEEP ME WELL
INFORMED ABOUT WHAT IS GOING ON
INSIDE OF BERNARD TYSON.
AND THE CONNECTION TO MY CARE
TEAM TO UNDERSTAND WHAT THEY
NEED TO DO NEXT IN MY OVERALL
CARE AND IN MOST CASES THAT'S
DONE VIA KP HEALTH CONNECT.
THE FUTURE THAT WE'RE SPEAKING
ABOUT IS HERE TODAY.
THIS PAST WEEKEND I WENT IN FOR
MY LAB TEST AS I AM PREPARING TO
SEE MY DOCTOR ON THIS FRIDAY
COMING UP, AS I LIKE TO SAY, AT
3:30.
AND I WENT IN TO ONE OF OUR LAB
FACILITIES AT ABOUT 9:30
SATURDAY MORNING TO HAVE MY
BLOOD DRAWN AT ABOUT 12:15 TO
12:30 MY PAGER WENT OFF ON MY
BLACKBERRY TO GIVE ME THAT
MESSAGE THAT SOME OF MY LAB
RESULTS ARE IN, I GOT HOME ABOUT
2-SOMETHING WENT ONLINE AND
PULLED UP MY TEST RESULTS.
EVERYTHING WAS LOOKING GOOD WITH
THE EXCEPTION OF ONE PARTICULAR
TEST WHICH WAS SLIGHTLY
ELEVATED, STILL WITHIN NORMAL,
BUT SLIGHTLY ELEVATED.
I WAS ABLE TO PUNCH ONE BUTTON
TO THEN GRASP THE LAST
NINE-TENTHS TO DO MY OWN TREND
ANALYSIS.
THEN I SENT THE NOTE TO MY CARE
NURSE, AS WELL AS MY PHYSICIAN
THAT I'LL SEE YOU ON NEXT
FRIDAY, BUT I AM CURIOUS WHAT
MIGHT BE CAUSING THIS SLIGHT
ELEVATION.
I GOT A MESSAGE BACK FROM MY
NURSE THAT SAID, THIS IS GREAT
RESULT, SLIGHT ELEVATION,
NOTHING TO WORRY ABOUT, SEE YOU
NEXT FRIDAY AND BY THE WAY, WE
WILL DISCUSS WHAT YOU ATE OVER
THE HOLIDAY SEASON.
[LAUGHTER]
I THINK THEY'RE GETTING TO KNOW
ME TOO WELL.
WE BELIEVE AT KAISER PERMANENTE
THAT WHAT I JUST DESCRIBED TO
YOU, WHAT IS AVAILABLE TO THE
8.7 MILLION MEMBERS WHO BELONG
TO KAISER PERMANENTE SHOULD IN
FACT BE AVAILABLE TO EVERY
SINGLE PERSON IN THIS COUNTRY.
WE BELIEVE STRONGLY THAT
INFORMATION TECHNOLOGY IN THE
HANDS OF EXPERIENCED CARING
PHYSICIANS AND CLINICAL STAFF
MAKES A DIFFERENCE FOR OUR
MEMBERS AND OUR PATIENTS EVERY
DAY.
WE BELIEVE THAT BY HAVING ALL
THE INFORMATION AVAILABLE AT ANY
GIVEN TIME THAT CAREGIVERS CAN
MAKE MORE INFORMED DECISIONS
ABOUT THEIR PATIENT'S HEALTH AND
PATIENTS CAN HELP MANAGE THEIR
OWN HEALTH MORE EFFECTIVELY.
AND BY APPLYING THE INFORMATION
TECHNOLOGY
THOUGHTFULTHOUGHTFULLY THE
INEFFICIENCIES OF TESTS AND
TREATMENT REDUNDANCIES,
UNNECESSARY OFFICE VISITS AND
COSTLY EMERGENCY ROOM VISITS CAN
BE REDUCED AND IN SOME CASES
ELIMINATED.
WE ACHIEVED BETTER HEALTH
OUTCOMES AS CONSEQUENCE OF OUR
EXPENSIVE INVESTMENT AND
INFORMATION TECHNOLOGY.
BEGINNING WITH THE KAISER
PERMANENTE ELECTRONIC MEDICAL
RECORD WHICH WE CALL KAISER
PERMANENTE HEALTH CONNECT THIS
VITAL TOOLS PROVIDES FOUNDATION
FOR OUR OUTSTANDING CARE.
BY BUILDING ON THAT FOUNDATION
WITH SUPPORTING TOOLS AND
TECHNOLOGIES, SUCH AS CARE
REGISTRIES WE ARE ABLE TO
IDENTIFY AT RISK POPULATIONS AND
PROVIDE CARE TEAMS WITH
ORGANIZED CONSISTENT PRIORITIZED
INFORMATION.
AS A RESULT WE HAVE IMPROVED
PEOPLE'S HEALTH BY BETTER
MEDICATION, LIFE SAVING
SCREENINGS AND PRO-ACTIVE
THERAPY.
WE REDUCE THE RATE OF MEDICATION
ERRORS BY 57%, USING BAR CODES
SCANNING AND ELECTRONIC
MEDICATION ADMINISTRATION.
WE LOWER THE HOSPITAL RATE FOR
OUR DIABETIC PATIENTS BY MORE
THAN 50%.
WE BELIEVE THAT BECAUSE OF THE
TECHNOLOGY AND EXCELLENT CARE
PROVIDERS AT KAISER PERMANENTE
THAT WE WILL REALIZE OUR VISION
THAT EVERY SINGLE PATIENT WHO IS
IN ANY ONE OF OUR HOSPITALS WILL
BE AS SAFE AS THAT PATIENT WOULD
BE ON AN AIRPLANE.
THAT'S OUR VISION, AND WE KNOW
NOW THAT WE CAN ACHIEVE IT WITH
THE TECHNOLOGY AND WITH THE
BRAIN POWER OF WONDERFUL PEOPLE
WHO WORK AT KAISER PERMANENTE.
KAISER PERMANENTE HAS SEEN
INTERCEPTION BETWEEN TECHNOLOGY
AND RESEARCH.
WITH RESULTS NOT ONLY
BENEFITTING KAISER PERMANENTE
MEMBERS BUT ALSO THE COMMUNITIES
AT LARGE.
OUR COLLECTION OF DATA FOR VERY
LARGE PATIENT POPULATIONS ENABLE
US TO SPOT TREADS IN MEDICATION
EFFECTIVENESS AND CARE OUTCOME
IN STUDIES FORMERLY IMPOSSIBLE
THROUGH SIZE AND SCOPE.
RESEARCH ASSISTED BY THIS
COMPREHENSIVE DEATH HEALTH DATA
AND INFORMATION TECHNOLOGY WE
FOUND, FOR EXAMPLE, THAT
UNVACCINATED CHILDREN ARE 23
TIMES MORE LIKELY TO GET
WHOOPING COUGH THAN CHILDREN WHO
ARE VACCINATED.
EXTREMELY OBESE CHILDREN HAVE
40% HIGHER RISK OF REFLUX
DISEASE OF THE ESOPHAGUS AND
THAT THERE IS A LINK BETWEEN
SMOKING, ALZHEIMER'S AND
DEMENTIA RISK.
WITH NEARLY FOUR MILLION MEMBERS
USING MY HEALTH MANAGER, THE
PERSONAL HEALTH RECORD AVAILABLE
ON OUR WEBSITE, KP.ORG IT'S
CLEAR THAT DEMAND FOR ONLINE
HEALTH CARE TOOLS IS GROWING.
OUR MEMBERS HAVE 24-7 ACCESS TO
HEALTH INFORMATION AND
COMMUNICATION TOOL TO REACH
THEIR PROVIDERS.
TODAY, KAISER PERMANENTE MEMBERS
ARE ON TRACK TO SEND MORE THAN
TEN MILLION SECURE E-MAILS TO
THEIR PHYSICIANS THROUGH MY
HEALTH MANAGER, AS WELL AS
REVIEW OVER 25 MILLION LAB
RESULTS AND TO MAKE FIVE PLUS
MILLION APPOINTMENTS ONLINE.
THAT'S JUST WHAT FOUR AND A HALF
OF OUR 8.7 MILLION MEMBERS WHO
ARE ACTIVELY USING MY HEALTH
MANAGER.
THESE SERVICES AND OVERALL
PORTFOLIO OF HEALTH INFORMATION
TECHNOLOGY TOOLS HAS REDUCED
UNNECESSARY IN-PERSON OFFICE
VISITS BY NEARLY 26%.
WE HAVE REDUCED EMERGENCY ROOM
VISITS BY MORE THAN 11%.
ALSO UT LIESING THIS TOOL TO
BETTER UNDERSTAND AND CAPTURE
LONGITUDINAL DATA THAT IS
ALLOWING US TO MAKE BETTER
DECISIONS IN HOW THE STAFF
MANAGES OUR FACILITIES ACROSS
THE UNITED STATES.
A MEDICAL RECORD IS MOST
EFFECTIVE WHEN IT IS ACCESSIBLE
TO BOTH THE PATIENT AND TO THEIR
PROVIDERS.
AS PATIENTS MOVE ACROSS
GEOGRAPHIES, PROVIDERS AND
INSURERS, MORT PILL OF THEIR
MEDICAL RECORDS -- PORTABILITY
WILL OF ESSENTIAL REQUIREMENT
FOR ELECTRONIC HEALTH RECORDS.
KAISER PERMANENTE HAS BEEN
WORKING ON THE CHALLENGE OF
CONNECTING THE NATION'S EMRS, WE
AGAIN THIS WORK WITH PILOT
PROGRAM TO LINK THE LARGEST
CIVILIAN ELECTRONIC HEALTH
RECORD WITH THE LARGEST
GOVERNMENTAL HEALTH RECORD, THAT
OF THE V.A.
CRUISING NHIN AS THE STANDARD WE
SHARE THE INFORMATION OF 1,000
OF OUR SHARED PATIENTS PROVIDE
PROVING THAT MORE COMPLETE
INFORMATION IS POSSIBLE WHEN
SHARED ACROSS DIFFERENT
PROVIDING ORGANIZATIONS.
WE ALL AGREE THAT WE NEED BETTER
HEALTH OUTCOMES AND MORE
EFFICIENT CARE NATIONALLY.
WE NOT ONLY BELIEVE THAT HEALTH
INFORMATION TECHNOLOGY PLAYS A
CRITICAL ROLE IN ACHIEVING
BETTER HEALTH OUTCOMES, AT
KAISER PERMANENTE WE'RE PROVING
THAT IT ACTUALLY DOES.
THANK YOU.
[APPLAUSE]
>> GOOD MORNING.
I'M PLEASED TO START BY SAYING,
I DON'T HAVE ANYWHERE NEAR AS
TRAUMATIC A STORY TO BEGIN WITH
AS BERNARD DID, BUT NONETHELESS
VERY PLEASED TO BE WITH YOU THIS
MORNING AND I WANT TO START BY
THANKING ERIC AND CHRISTINE AS
WELL AS SECRETARY SEBELIUS,
DR. SUMMERS, DR. BLUMENTHAL FOR
HOSTING THIS GREAT EVENT TODAY.
at&t IS PLEASED TO HAVE THE
CHANCE TO ENGAGE AND COLLABORATE
WITH POLICY MAKERS ON HEALTH
INFORMATION TECHNOLOGY WHICH WE
BELIEVE HOLDS GREAT POTENTIAL
FOR IMPROVING THE U.S. HEALTH
CARE SYSTEM.
WE BELIEVE WE HAVE UNIQUE
PERSPECTIVE ON THE PROMISE THAT
INFORMATION TECHNOLOGY HOLDS FOR
IMPROVING ACCESS TO HEALTH CARE
IN THIS COUNTRY.
WE'RE LARGE SELF INSURED
EMPLOYER WITH OVER A MILLION
LIVES UNDER COVERAGE.
WE'RE DEEPLY INVOLVED IN THE
HEALTH INFORMATION TECHNOLOGY
AND MOBILE HEALTH MARKETS AS
BUSINESSES, AND WE'RE ALSO
ACTIVELY ENGAGED WITH DOSIA
CONSORTIUM IN DEVELOPING A
PERSONAL HEALTH RECORD PLATFORM
FOR THE BENEFIT OF OUR
EMPLOYEES.
AT at&t WE HAVE A FIRM BELIEF
THAT THE USE OF MOBILE
TECHNOLOGIES AND SMART NETWORKS
CAN IMPROVE THE QUALITY OF CARE,
IT CAN REDUCE COSTS AND
CONTRIBUTE TO A HEALTHIER WORLD.
AND NOW IS CERTAINLY THE TIME,
ACCORDING TO THE CENTERS FOR
MEDICARE AND MEDICAID SERVICES,
ABOUT $2.5 TRILLION WAS SPENT ON
HEALTH CARE IN THE U.S. IN 2009,
INEFFICIENCIES ABOUND AND ONE OF
THE BIG PROBLEMS IS A LACK OF
TIMELY ACCESS TO THE CRITICAL
INFORMATION THAT'S REQUIRED TO
DELIVER QUALITY CARRY
EFFICIENTLY.
NOW, WHAT WE'RE DISCUSSING HERE
THIS MORNING IS A NATIONAL
CHALLENGE, IT'S ONE THAT THE
ENTIRE HEALTH CARE SECTOR NEEDS
TO ADDRESS TO ENSURE THAT WE
HAVE THE FOUNDATION FOR BOTH
BROAD-BASED ECONOMIC GROWTH AND
NATIONWIDE IMPROVEMENT IN HEALTH
CARE.
I AM GLAD TO SEE THAT THE PCAST
HAS TAKEN ON THESE IMPORTANT
QUESTIONS WHILE I'VE NOT YET HAD
THE OPPORTUNITY TO FULLY REVIEW
THE REPORT AND CAN'T COMMENT ON
ITS SPECIFICS I CAN TELL YOU
THAT I'M HERE TODAY BECAUSE OF
HOW IMPORTANT at&t BELIEVES IT
IS TO DRIVE FULL NATIONWIDE
DEPLOYMENT OF HEALTH INFORMATION
TECHNOLOGY.
IMPROVING THE FUNCTIONING OF OUR
HEALTH CARE SYSTEM WE BELIEVE IS
VITAL TO OUR ECONOMIC INTERESTS
AND TO OUR CONTINUING ABILITY TO
COMPETE INTERNATIONALLY.
NOW, IMPROVING CARE AND REDUCING
COSTS ARE VITAL GOALS FOR EVERY
BUSINESS.
FOR at&t IN 2009 WE OFFERED
HEALTH CARE BENEFITS TO SOME 1.2
MILLION INDIVIDUALS, THOSE ARE
EMPLOYEES, RETIREES, AND THEIR
DEPENDENTS.
SO YOU CAN TELL I'M SURE THAT
WE'VE GOT SERIOUS SKIN IN THE
GAME FROM MANY ANGLES HERE.
WE HAVE ALREADY COMMITTED TO
BRINGING OUR ASSETS, TALENT AND
REAR SOURCES TO BEAR ON HELPING
THE HEALTH CARE INDUSTRY TAKE
ADVANTAGE OF OUR TECHNOLOGIES TO
SOLVE THE MANY CHALLENGES IT
FACES.
NOW AS ANY HEALTH CARE
PROFESSIONAL WILL ATTEST, HEALTH
CARE IS A HIGHLY MOBILE
BUSINESS, MEDICAL INFORMATION
NEEDS TO FOLLOW THE PATIENT,
SEARCHING FOR IT ONCE THE
PATIENT IS IN CRISIS CAN HINDER
THE QUALITY OF CARE AND OF
COURSE BE VERY EXPENSIVE.
MANY OF OUR HEALTH CARE INDUSTRY
SOLUTIONS ARE DESIGNED TO
ADDRESS EXACTLY THIS PROBLEM.
ONE OF THE KEY CHALLENGES, FOR
EXAMPLE, THAT HEALTH I.T.
INDUSTRY FACES IS ALLOWING FOR
CONNECTIVITY AMONG EXISTING
ELECTRONIC MEDICAL RECORD
DEPLOYMENTS, THUS PROTECTING
MUCH OF THE INVESTMENT THAT'S
ALREADY BEEN MADE IN DIGITIZING
AND STORING MEDICAL DATA.
at&t HEALTH CARE COMMUNITY
ONLINE HELPS WITH THAT, ALLOWING
HEALTH CARE PROVIDERS, STATE AND
FEDERAL GOVERNMENT AGENCIES TO
SAVE TIME AND MONEY BY USING THE
EXISTING I.T. INFRASTRUCTURE AND
INTEGRATING IT WITH NEW SERVICES
AND AND APPLICATIONS TO ENABLE
COMMUNITY WIDE EXCHANGE OF
ELECTRONIC MEDICAL RECORDS.
ALSO BELIEVE THAT MOBILE AND
TELEHEALTH SOLUTIONS OFFER
EXCITING POTENTIAL TO IMPROVE
THE WAY HEALTH CARE IS
DELIVERED.
TAKE ONE EXAMPLE, FIRM WOUND
TECHNOLOGY NETWORK USES VIDEO
CONFERENCING AND MOBILITY
SOLUTIONS TO IMPROVE THE QUALITY
AND SPEED WITH WHICH THEY TREAT
PATIENTS WOUNDS.
AND THEIR RESULTS ARE VERY
IMPRESSIVE.
THEY HAVE REDUCED
HOSPITALIZATIONS BY 95%, HEALED
WOUNDS 50% FASTER THAN
HOSPITAL-BASED WOUND CARE
CENTERS AND REDUCED COST FOR
PAYERS BY UP TO 85%.
NOW IN ADDITION TO THOSE QUICK
EXAMPLES, at&t PLANS TO
PARTICIPATE IN A SERIES OF PILOT
PROGRAMS AND TRIALS THAT WILL
TEST SOME OF OUR KEY
TECHNOLOGIES WITH PATIENTS AND
PROVIDERS.
EXAMPLES INCLUDE MEDICINE
BOTTLE, IS THAT REMIND PATIENTS
TO TAKE PILLS ON SCHEDULE.
DEVICES THAT MONITOR PATIENT
HEART OR GLUCOSE LEVELS FROM THE
COMFORT OF THEIR HOMES.
AUDIO AND VIDEO LINKS THAT CAN
REPLACE THE NEED FOR IN-PERSON
VISITS TO DOCTORS AND MORE.
WE BELIEVE SOLUTIONS LIKE THE
ONES THAT WE'RE CURRENTLY
DELIVERING AND TESTING AS WAS
MENTIONED BEFORE, CAN BE
TRANSFORMATIVE TECHNOLOGIES.
IN FACT SIMILAR TO THE WAY
ATMs TRANSFORMED BANKING
TRANSACTIONS OR FOR ONLINE
BOOKING OF TRAVEL REQUIREMENTS.
AS FURTHER EVIDENCE OF OUR
COMMITMENT, WE'VE JUST ANNOUNCED
THE DEDICATED PRACTICE CALLED
FOUR HEALTH, at&t FOUR HEALTH
WILL EXPEDITE DELIVERY OF
CLOUD-BASED SOLUTIONS
SPECIFICALLY FOR THE HEALTH CARE
SEGMENT.
SUMMING IT UP, WE BELIEVE IT'S
VITAL FOR HEALTH INFORMATION
TECHNOLOGY TO BE WIDELY AND
RAPIDLY ADOPTED ACROSS ALL
SEGMENTS OF THE HEALTH CARE
SECTOR, WE'RE SEEING SUBSTANTIAL
PROGRESS AS HAS BEEN MENTIONED
BUT THERE'S MUCH STILL TO BE
DONE SO WE'RE VERY PLEASED THAT
P CAST FOCUSED ITS EFFORTS ON
THE IMPORTANT ISSUE OF DRIVING
HEALTH INFORMATION TECHNOLOGY
ADOPTION NATIONWIDE.
WE BELIEVE THIS GOAL IS VITAL TO
IMPROVE HEALTH OUTCOMES, DRIVE
DOWN HEALTH CARE COSTS, SPUR
INVESTMENT AND CREATE QUALITY
HI-TECH KNOBS HERE AT HOME.
IMPROVING THE NATION'S HEALTH
CARE SYSTEM TRULY A GOAL OF
GENERATIONAL IMPORTANCE AND ONE
THAT WILL HELP ENSURE OUR
COUNTRY'S COMPETITIVENESS FOR
DECADES GOING FORWARD.
WE AT at&t LOOK FORWARD TO THE
DAY WHEN THESE HEALTH
INFORMATION TECHNOLOGIES ARE
WIDELY DEPLOYED AND BENEFITTING
ALL AMERICANS.
WE REMAIN COMMITTED TO IMPROVING
THE QUALITY OF CARE, REDUCING
COSTS AND CONTRIBUTING TO A
HEALTHIER WORLD, WE'RE EAGER TO
CONTINUE WORKING WITH THE
ADMINISTRATION ON THESE
IMPORTANT ISSUES.
THANK YOU FOR YOUR ATTENTION
THIS MORNING.
[APPLAUSE]
>> THANK YOU, MR. ARCHER,
MR. TYSON FOR BRINGING THE
PRIVATE SECTOR PERSPECTIVE TO
THIS AND TAKING THE TIME AND
EFFORT TO BE HERE WITH US TODAY.
WE KNOW YOU TRAVELED A LONG
DISTANCES TO BE HERE.
I ALSO WANT TO THANK OUR PCAST
COLLEAGUES, ERIC LANDER, CHRIS
CASSEL, CRAIG MUNDY FOR THEIR
CONTRIBUTION AND FOR LAYING OUT
VERY, VERY IMPORTANT CHALLENGE
FOR US IN THE DEPARTMENT OF
HEALTH AND HUMAN SERVICES.
AND OF COURSE I WANT TO ADD MY
THANKS TO SECRETARY SEBELIUS AND
LARRY SUMMERS FOR ATTENDING AND
STARTING OFF THE DISCUSSION
TODAY.
MOUNTAIN CLIMBERS KNOW THE
FEELING OF WORKING HARD TO GET
TO A SUMMIT ONLY TO REALIZE THAT
THERE MAY BE THREE, FOUR, FIVE
OR MORE SUMMITS STILL TO CLIMB.
AT THE OFFICE OF NATIONAL
COORDINATOR AND CENTER FOR
MEDICARE AND MEDICAID SERVICES
HERE IN THE DEPARTMENT OF HEALTH
AND HUMAN SERVICES WE HAVE BEEN
WORKING VERY HARD TO IMPLEMENT
THE HI-TECH AGENDA LAID OUT FOR
US BY CONGRESS OF THE UNITED
STATES AND THE PRESIDENT AS PART
OF THE STIMULUS BILL OF 2009.
WE THOUGHT WE WERE DOING A
PRETTY GOOD JOB.
WE WERE -- THOUGHT WE WERE DOING
OKAY.
THE PCAST FOLKS HAVE LANDED ON
THE NEXT PEAK AND SAID TO US IN
EFFECT, CONGRATULATIONS ON WHAT
YOU'VE DONE, BUT THERE'S A WHOLE
LOT MORE STILL TO DO.
IF YOU SET YOUR VISION HIGH
ENOUGH, IF YOU WORK HARDER, IF
YOU'RE NIMBLE, IF YOU'RE
AMBITIOUS, IF YOU'RE QUICK AND
DECISIVE.
WE WELCOME THAT VISION, THIS
ADMINISTRATION IS SHOWING YOU
GRAPHICALLY RIGHT NOW THROUGH
THIS PARTICULAR REPORT, THE
IMPORTANT DESIGNS TO THE ADVICE
OF THE NATION'S LEADING
SCIENTISTS AND TECHNOLOGISTS AND
WE SHARE THAT APPRECIATION WE
WISH IT CAME WITH A HELICOPTER
BUT WE THINK THAT WILL COME,
TOO.
WHAT HAVE WE BEEN UP TO FOR THE
LAST 20 MONTHS OR SO
IMPLEMENTING THE HI-TECH ACT.
WE'VE BEEN WORKING ON TWO OF THE
MOST IMPORTANT PRIORITIES OF
THAT LEGISLATION.
THE FIRST TO PROMOTE ADOPTION OF
HEALTH INFORMATION TECHNOLOGY.
ESPECIALLY ELECTRONIC HEALTH
RECORDS.
SOME OF THE BENEFITS HAVE BEEN
DISCUSSED BY OUR
PANELISTPANELLISTS ALREADY HERE
TODAY.
AND SECONDLY TO ACCOMPLISH
SOMETHING THAT EQUALLY
IMPORTANT, THAT IS THE
MEANINGFUL USE OF ELECTRONIC
HEALTH RECORDS.
THERE'S BEEN REALLY BIPARTISAN
SUPPORT FOR THIS AGENDA
PROMOTING HEALTH INFORMATION
TECHNOLOGY, A WIDESPREAD
RECOGNITION OF THE CAPACITY EVER
IT TO ACCOMPLISH THE KINDS OF
SEEMINGLY MIRACULOUS THINGS THAT
KAISER HAS ALREADY PUT ON THE
TABLE AND THAT CHRIS CASSEL
DESCRIBED IN HER USE CASES.
CONGRESSMAN DATED US FIRST OF
ALL TO WORK ON ADOPTION, I THINK
THE PERCEPTION WAS THAT, BEFORE
YOU CAN INTER-OPERATE YOU NEED
TO OPERATE.
WE NEED TO GET DATA, CLINICAL
DATA IN TO ELECTRONIC FORM
BEFORE WE CAN SEND IT SHOOTING
AROUND OUR HEALTH CARE SYSTEM IN
THE WAY THAT ARE SO POWERFUL AS
DESCRIBED.
AND BY THE WAY, IN THE PROCESS
OF PROMOTING THAT ADOPTION, WE
THINK THAT THE FEDERAL
GOVERNMENT THROUGH ITS
LEADERSHIP HAS UNLEASHED
ENORMOUS AMOUNT OF INNOVATION,
SOME OF WHICH WAS DESCRIBED TO
YOU BY MR. ARCHER, BUT IT'S
HAPPENING THROUGHOUT OUR HEALTH
CARE SYSTEM AND THROUGHOUT I.T.
INDUSTRY, SOMEONE ONCE DESCRIBED
TO ME THAT THE DAY AFTER THE
IPAD WAS RELEASED HIS COMPANY
WHICH PRODUCED ELECTRONIC HEALTH
RECORDS HAD AN iPAD BASED
SOLUTION TO THE ELECTRONIC
HEALTH RECORD ALREADY AVAILABLE.
THAT KIND OF EXPLOSION OF NEW
THINKING, I DON'T THINK WOULD
HAVE BEEN POSSIBLE WITHOUT
LEADERSHIP SHOWN THROUGH THE
HI-TECH ACT.
WE ALSO HAVE BEEN COMMITTED TO
OBTAINING MEANINGFUL USE.
THE CONGRESS IS VERY CLEAR THAT
THEY DIDN'T WANT COMPUTERS TO BE
DOOR STOPS FOR PAPER WAIT IN THE
OFFICE OF -- THEY WANTED THOSE
TECHNOLOGIES TO BE USED FOR
HEALTH IMPROVEMENT PURPOSES AND
THAT HAS BEEN A GUIDING
PRINCIPLE OF THE CENTER FOR
MEDICARE AND MEDICAID SERVICES
AT THE OFFICE OF NATIONAL
COORDINATOR ENOUR DESIGN OF THE
MEANINGFUL USE FRAMEWORK.
THERE ARE SERIES OF THEM THAT
ARE LAID OUT IN THE REGULATION
CREATING THE MEANINGFUL USE
FRAMEWORK AND IT HAS PUT
PATIENTS FIRST IN TERMS OF
PATIENT INVOLVEMENT WITH THEIR
CARE IN TERMS OF GUIDING
PROVIDERS TO PROVIDER HEALTH
SOLUTIONS RATHER THAN TECHNOLOGY
SOLUTIONS.
WE HAVE ALSO ENACTED SERIES OF
SUPPORTING REGULATIONS.
ONE TO CREATE STANDARDS AND
CERTIFICATIONS OF ELECTRONIC
HEALTH RECORDS.
AND WE HAVE ACTUALLY BEGUN THE
PROCESS WE BELIEVE OF PREPARING
THE WAY FOR THE KINDS OF
SOLUTIONS THAT THE PCAST REPORT
HAS ADVOCATED.
UNIVERSAL STANDARDS PROMOTE
INTER-OPERABILITY AND ENABLE
COMMUNICATION ACROSS ELECTRON I
GO HEALTH RECORDS, AS WELL AS
GUARANTEEING THE FUNCTIONALITY
OF THE RECORDS THAT ARE ADOPTED.
WE'VE CREATED A PROCESS TO
CERTIFY ELECTRONIC HEALTH
RECORDS AS CAPABLE OF MEANINGFUL
USE.
OVER 130 ELECTRONIC HEALTH
RECORDS AND ELECTRONIC MODULES
HAVE BEEN CERTIFIED IN THE LAST
TWO TO THREE MONTHS GOING
BASICALLY FROM A DEAD STOP TO
FULL SPEED WITH THE PROVISION OF
INFORMATION TO PROVIDERS OF CARE
ABOUT THE CAPABILITY OF
ELECTRONIC HEALTH RECORDS ON THE
MARKET.
WE KNOW, THOUGH, THAT JUST
PROVIDING THE TECHNOLOGY WILL
NOT BE SUFFICIENT SO WE'VE BEEN
CREATING THE CAPABILITY TO
SUPPORT WILLING PROVIDERS TO
BECOME MEANINGFUL USERS.
THERE ARE NOW 62 REGIONAL
EXTENSION CENTERS COVERING THE
ENTIRE GEOGRAPHY OF THE UNITED
STATES WHICH ARE AVAILABLE TO
PROVIDERS ABLE TO INDEPENDENTLY
ADOPT MEANINGFUL USE ELECTRONIC
HEALTH RECORDS.
WITH THE HELP OF THOSE REGIONAL
EXTENSION CENTERS WE HAVE NOW
ENROLLED ALREADY FIRST TEN
MONTHS OF THEIR EXISTENCE 25,000
PRIMARY CARE PHYSICIANS TO
OBTAIN TECHNICAL SUPPORT
SERVICES ON THE WAY TOWARD
ADOPTING A MEANINGFUL USE OF
ELECTRONIC HEALTH RECORDS.
WE HAVE NORTH CAROLINA WIDE
PROGRAM OF COMMUNITY WHOSE
PURPOSE TO DEMONSTRATED WHAT IS
POSSIBLE IN A COMMUNITY TO DO
WITH INFORMATION TECHNOLOGY
THROUGH IMPROVING OUTCOMES OF
CARE AND IMPROVING EFFICIENCY OF
CARE.
THESE ARE COMMUNITY-BASED
ACTIVITIES COLLABORATIVES OF
PROVIDERS, ENSURERS, HEALTH CARE
ORGANIZATIONS AND LOCAL
EMPLOYERS, CITY AND STATE
GOVERNMENTS THAT ARE WORKING
TOGETHER TO DEMONSTRATE THE
CAPABILITY OF I.T., IN EFFECT TO
BE BEACONS FOR THE REST OF THE
NATION.
THERE IS SHORTAGE OF 50,000
HEALTH I.T. WORKERS WITHOUT
WHOSE HELP ALL OUR EFFORTS TO
GET OPERATING ELECTRONIC HEALTH
SYSTEMS UP AND RUNNING WILL BE
FOR NAUGHT.
WE ARE NOW SPENDING $120 MILLION
THROUGH 84 COMMUNITY COLLEGES
TRAINING 40,000 HEALTH
INFORMATION TECHNOLOGY
PROFESSIONALS, 3,000 ENROLLED IN
THE FIRST COHORT IN SEPTEMBER.
I VISITED WITH THE FIRST
GRADUATING CLASS OF ONE OF THOSE
PROGRAMS, VIRTUALLY ALL OF THE
GRADUATES HAVE JOBS EITHER WITH
PROVIDERS OF CARE OR WITH
VENDORS OF HEALTH I.T. SERVICES
OR WITH LOCAL GOVERNMENTS, THEY
HAVE BEEN SUCCESSFUL
DEMONSTRATING THAT HI-TECH STIP
MU HUSBAND PROGRAM CAN DEVELOP
OPPORTUNITIES FOR NEW JOBS THAT
HAVE A FUTURE IN AN EXPANDING
ELECTRONIC SECTOR.
WE HAVE INVESTED IN CUTTING EDGE
RESEARCH THROUGH FOUR CONSORTIA
OF RESEARCH INSTITUTIONS THAT
ARE WORKING ON THE TECHNOLOGIES
OF THE FUTURE.
CAN O MAKE PRIVACY AND SECURITY
MORE EFFECTIVE THAT CAN MAKE
SYSTEMS OF ELECTRONIC HEALTH
RECORDS MORE USEFUL.
AND WE'VE ALSO BEEN
COLLABORATING NOT JUST WITH THE
PRIVATE SECTOR BUT WITH STATE
GOVERNMENT, WITH THEIR
LEADERSHIP IN LAYING THE GROUND
WORK.
BECAUSE THE SPACE ARE VITAL
PARTICIPANTS IN THE HEALTH OF
OUR POPULATION, THEY CONTROL
PUBLIC HEALTH DATA, MEDICAID
DATA, THEY LICENSE PROVIDERS,
THEY ARE CRITICAL PARTICIPANTS
IN MAKING HEALTH INFORMATION
EXCHANGE AND INTER-OPERABILITY
POSSIBLE.
ALL THAT IS FINE, BUT PCAST HAS
SAID TO US IN EFFECT, DON'T LOSE
TRACK OF THE HUGE BENEFITS OF
INTER-OPERABILITY AND DON'T
FORGET TO BUILD IN THAT CAPACITY
AS EVERY STEP OF THE WAY.
AND WE ARE GOING TO LOOK AND
INCORPORATE THOSE
RECOMMENDATIONS AS WE CAN IN TO
OUR WORK, USING OUR FEDERAL
ADVISORY COMMITTEES, WHICH HAVE
SERVED UP ADMIRABLY UP TO THIS
POINT.
LOOKING AT OUR STANDARD AND
CERTIFICATION CRITERIA TO SEE
HOW THEY NEED TO BE MODIFIED
LOOKING AT THE MEANINGFUL USE
FRAMEWORK TO SEE HOW THE
MEANINGFUL USE FRAMEWORK CAN
ASSIST WITH THE INTER-
OPERABILITY CAPABILITY.
WE SAID IN OUR MEANINGFUL USE
REGULATION PUBLISHED LAST JULY
THAT THE NEXT PHASE OF
MEANINGFUL USE WOULD EMPHASIZE
HEALTH INFORMATION EXCHANGE.
SO THE PCAST RECOMMENDATIONS
COULD NOT COME IN A MORE -- AT A
MORE TIMELY PLACE IN OUR AGENDA.
OUR COMMITMENT TO THE SECURITY
OF HEALTH INFORMATION REMAINS
RESOLUTE.
IT IS ABSOLUTELY ESSENTIAL THAT
WE HAVE THE TRUST OF THE
AMERICAN PEOPLE TO CREATE A
VIABLE, NATIONAL
INTER-OPERATABLE HEALTH
INFORMATION SYSTEM BASED ON
MODERN ELECTRONIC TECHNOLOGY.
WE HAVE TO KEEP PATIENTS AND
CONSUMERS FIRST AT EVERY STEP
ALONG THE WAY AND WE KNOW THAT
PATIENTS AND CONSUMERS VALUE THE
BENEFITS OF INTER-OPERABILITY
BUT ALSO WORRY ABOUT THE RISK.
THE TECHNOLOGICAL OPPORTUNITY
CREATED BY THE IBF TAGGING DATA,
TAGGING HEALTH INFORMATION WITH
PATIENT PREFERENCES FOR
EXCHANGEABILITY AND
AVAILABILITY.
IS A VERY IMPORTANT
CONTRIBUTION.
IT NEEDS TO BE COMPLEMENTED BY A
RANGE OF POLICY THAT PROVIDE A
COMPLETE AND COMPREHENSIVE
PACKAGE OF SOLUTIONS TO THE
PRIVACY CHALLENGES WE FACE.
WE ARE COMMITTED TO MOVING
FORWARD WITH THAT POLICY AGENDA
AS WE MOVE FORWARD WITH THE
TECHNOLOGY AGENDA.
SO, TO REITERATE WE WELCOME THE
P CAST REPORT.
WE THINK IT PUSHES US FORWARD,
SETS NEW GOALS FOR US, PROVIDES
EXACTLY THE KIND OF EXTERNAL
ADVICE THAT HAS MADE OUR POLICY,
WE THINK TO, THIS POINT
SUCCESSFUL WHERE THEY HAVE BEEN
SUCCESSFUL.
WE LOOK FORWARD TO WORKING WITH
OUR PCAST COLLEAGUES AS WE MOVE
FORWARD.
I ALSO WANT TO SAY THAT PCAST
REPORT WILL BE ONLINE WITH
REQUEST FOR COMMENT FROM THE
OFFICE OF THE NATIONAL
COORDINATOR BY THE END OF THE
DAY TODAY, IT WILL BE OPEN TO
COMMENTS, INVITATION FOR
COMMENTS WILL BE OPEN IN THE
FEDERAL REGISTER FOR 30 DAYS
UNTIL MIDDLE OF JANUARY.
THANKS VERY MUCH FOR YOUR
ATTENTION.
[APPLAUSE]
>> I'D LIKE TO THANK DAVID
BLUMENTHAL AND HIS COLLEAGUES AT
THE OFFERS OF THE NATIONAL
COORDINATOR TO USE YOUR
METAPHOR, YOU HAVE INDEED BE A
SHERPA THAT BROUGHT US UP TO
GREAT HEIGHTS ALREADY.
IT'S EXTRAORDINARY WHAT HAPPENED
IN THE LAST TWO YEARS WITH
RESPECT TO HEALTH INFORMATION
TECHNOLOGY AND SPIRIT WITH WHICH
YOU TAKE OUR SUGGESTIONS OF
RECOGNIZING THERE ARE EVEN MORE
PEAKS TO CLIMB IS EXACTLY THE
RIGHT SPIRIT THAT WE SHOULD NOT
FORGET JUST HOW EXTRAORDINARILY
FAR WE HAVE COME IN THE COURSE
OF THE PAST TWO YEARS UNDER YOUR
LEADERSHIP AND VERY HARD WORK OF
YOUR COLLEAGUES.
SO I'D VERY MUCH LIKE TO THANK
YOU.
THE FLOOR IS OPEN FOR COUPLE OF
QUESTIONS, I KNOW WE'RE RUNNING
A LITTLE LATE RELATIVE TO THE
SCHEDULE WE'D HOPED FOR.
SO WE MIGHT TAKE FIVE, TEN
MINUTES AT MOST OF QUESTIONS.
BUT SEVERAL OF US WILL BE
AVAILABLE TO STICK AROUND AND
HAVE SUBSEQUENT CONVERSATIONS SO
LET ME TURN THE FLOOR OPEN TO A
COUPLE OF QUESTIONS IF THERE ARE
ANY.
OR IF NOT, THAT'S OKAY, TOO.
A QUESTION IN THE BACK.
>> I JUST WANTED TO CLARIFY, IT
WAS INTERESTING THAT YOU WOULD
MOVE AS QUICKLY AS POSSIBLE ON
THE RECOMMENDATIONS BUT THERE
WILL BE CERTAINLY CHALLENGES AND
THERE HAS BEEN -- FROM HOSPITALS
AND PHYSICIANS ON
INTER-OPERABILITY AND I
WANTED -- THIS IS QUESTION FOR
DR. BLUMENTHAL.
I WONDERED HOW DIFFICULT WILL IT
BE FOR YOU TO IMPLEMENT THE
SUGGESTIONS FROM THE --
>> WE ARE -- WE THINK THAT THE
TECHNICAL SOLUTIONS ARE VERY
PROMISING AND VERY INTERESTING,
WE THINK IT'S THE RIGHT WAY TO
GO.
WE ARE GOING GET FEEDBACK FROM
OUR ADVISORY COMMITTEE TO
REASSURE US ON THAT SCORE.
WE'RE GOING TO BE CONSULTING
WITH THE BEST MINDS IN THE
COUNTRY ON THE TECHNICAL ASPECTS
OF THE IMPLEMENTATION OF THESE
RECOMMENDATIONS.
AND OF COURSE UNTIL YOU GET IN
TO THE DETAILS YOU CAN NEVER
KNOW WHERE EXACTLY WHERE THE
PROBLEMS ARE.
WE'RE REASSURED BY THE FACT THAT
THIS IS NOT NEW TECHNOLOGY, IT'S
BEEN IMPLEMENTED IN OTHER
SECTORS OF THE ECONOMY.
WE'RE IN A SENSE TRYING TO CATCH
UP WITH OTHER SECTORS.
I THINK THE UNIQUE THING IN
HEALTH CARE IS THE NEED FOR
PRIVACY AND SECURITY ASSURANCES.
AND WE THINK THAT THERE ARE
ASPECTS OF THIS SET OF SOLUTIONS
THAT WILL GIVE US NEW
CAPABILITIES IN THAT AREA.
SO I THINK THAT ON THE WHOLE
THINGS LOOK VERY POSITIVE.
THERE ARE A LOT OF VERY DETAILED
ACTIVITIES TO UNDERTAKE,
STANDARDS TO WRITE, I AM PRI MEN
TAKES SPECIFICATIONS TO WRITE,
IMPLEMENTATION PILOTS,
DEMONSTRATIONS EVER FEESABILITY
AND THEN PUBLICATION OF THOSE,
ALL THOSE THINGS AS OPEN
STANDARDS THAT ARE ACCESSIBLE TO
THE INDUSTRY AS A WHOLE.
WE'VE BEEN DOING THIS WITH OTHER
FORMS -- TO CREATE OTHER FORMS
OF CONNECTIVITY.
WE HAVE OTHER PROJECTS UNDERWAY
THAT INVOLVE CREATING THOSE
STANDARDS.
WE HAVE HA SENSE OF HOW MUCH
IT'S GOING TO TAKE AND WE THINK
IT'S DOABLE, PRECISE TIMELINE I
THINK ONE CAN PLAN BUT HAS --
ONE THAT WE HAVE TO BE OPEN TO
THE CHANCE, TO POSSIBILITY THAT
SURPRISES WILL OCCUR.
>> OTHER QUESTIONS?
IF NOT, LET ME THANK ALL OF YOU
FOR COME AND THE PCAST REPORT
ITSELF IS ALREADY ON THE PCAST
WEBSITE.
YOU CAN DOWNLOAD IT TODAY, THE
REQUEST FOR COMMENTS BY THE ONC
IS OUT BY THE END OF THE DAY.
THANK YOU ALL AND I WANT TO
PARTICULARLY THANK SPEAKERS FROM
THE PRIVATE SECTOR FOR COMING
AND POINTING TO THE FUTURE FOR
US OF WHAT IS POSSIBLE.
I APPRECIATE YOU'RE TAKING THE
TIME TO COME AND JOIN US.
THANK YOU.
[APPLAUSE]