Electronic health records (EHRs) shouldn't be the sole solution for implementing healthcare reform, according to a report drafted by the Center for Connected Health (Boston).
The study was derived from an online Community Health Discussion including nearly 30 participants and was submitted to President Barack Obama's Transitional Health Policy Team, led by Secretary of Health and Human Services Tom Daschle.
The discussion took place late last year and was sponsored by the Center for Connected Health, a division of Partners HealthCare (Boston), which is an integrated health system founded in 1994 by Brigham and Women's Hospital and Massachusetts General Hospital.
The center's study comes at a time when Obama is pitching $111 billion of the upcoming $825 billion stimulus plan to go toward healthcare. About $87 billion would go for Medicaid; $20 billion to improve health information technology; and around $4 billion to improve preventative care.
"We started out with a concern that we still have," Joseph Kvedar, MD, director of Center for Connected Health, told Medical Device Daily. "In everyone's effort to do the right thing, and I must stress that everyone wants to do the right thing ... but we wanted to point out that EHR, while a terrific tool ... it's not fundamentally transformational healthcare reform."
Kvedar stated that in no way was he saying that EHRs should be discounted, but the emphasis on implementing the technology shouldn't be stressed as much.
Citing findings from the study, he said that 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 throughout the U.S.
"We would make the argument that [EHR] goes a small way of going toward transformative healthcare reform," he said. "Getting everyone on an electronic EHR system is a good start. Involving patients in their own care is a more powerful way of reducing costs."
But saying a patient needs to be more involved and getting a patient to take more of a personal stake in their own health are two different things.
Kvedar said that for so long, patients have solely relied on physicians for healthcare needs but now with the advent of the Internet, patients are slowly becoming more educated regarding their healthcare needs.
He pointed out that one of the tools the Center for Connected Health used to make patients more aware were special blood pressure cuffs with sensors. The cuff takes a reading and develops a personalized web page for the individual and interprets their lifestyle and what the readings mean.
Kvedar said by adding in a coaching component to guide the patients and leading them toward positive lifestyle changes.
The Center for Connected Health also has 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 can reduce re-hospitalizations by improving patients' understanding of their condition, and providing on-going nursing support and review of vital signs, such as heart rate and blood pressure, while the patient is at home.
These kinds of solutions are much more reliable than simply adding more staff across the board.
"We are understaffed with healthcare providers today ... plus the growth in chronic illness is staggering," Kvedar told MDD. "All of the chronic illness [statistics] are going up and we're not training enough providers. Even if you doubled the number of providers you'd never catch up to adequately serve those suffering from chronic illnesses. The game is already lost on that. We must reform the whole way we provide care or we're just not going to be able to do it."
He added that he personally would like to see healthcare providers paid for the quality of care they apply instead of the number of transactions they receive. "We need to push hard to pay doctors based on quality as opposed to the patients they see. That will start to create the space where more innovations [can] flourish."
But before any such measures can be put into place, Obama's robust stimulus bill must pass. As of press time, it was expected the proposed financial overhaul would steamroll through the House but could hit some severe snags in the Senate.