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One of the big promises of health IT is that it will help improve health care by capturing vast amounts of data about treatments, procedures and payments.
Using electronic health record systems, registries, and other health IT systems, clinical data will be crunched to find how one treatment protocol performed against another. This data will also be used to make the case for re-orienting health care payment incentives toward preventive or chronic care and away from the acute care side of the ledger.
In the coming era, informatics will be the rule, embedded in health IT.
I’ve been thinking about how health IT and these analytic tools might affect the government’s role as the health care payer and provider of last resort for the elderly and indigent.
Certainly health care IT can be used to target and to better understand the needs of these populations, which account for a disproportionate amount of our health care costs.
And in fact state and local government health care and Medicaid agencies are ramping up in this area. According to recent survey by the Commonwealth Fund, the greatest number of state e-health activities in 2007 were in the public health arena.
The tool most widely used by these agencies is a basic health registry, a sometimes electronic, sometimes paper-based tool for organizing information on people who have a particular disease or condition. These registries are the building blocks of more sophisticated electronic health records systems and health information exchanges of the future.
One local government trend-setter in public health IT has been Orange County, Calif., which is using a Web-based system to improve tracking and health care coordination of 25,000 of its residents who are impoverished, chronically ill, or homeless. According to our story in the upcoming issue of Government Health IT, the system arose from the interest by emergency room physicians for better clinical and diagnostic data on its poorer, transient patients.
Because of their general lack of mobility, tele-health systems and services are also in high demand by this population. State and local governments – and state Medicaid agencies in particular – are on the forefront of using this technology. In fact, tele-health services are used in about half of state Medicaid programs, according to the Commonwealth Fund.
In the current excitement over health IT, government is most often looked upon as a standards-setter and regulator. But it’s important to recognize that public health agencies are often the only health care option for much of the nation’s disadvantaged. And it is in this area that government investment in health IT will show some of its greatest returns and rewards.
By Paul McCloskey
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