One of the big promises of information technology is that it could help improve health care by capturing vast amounts of data about treatments, procedures and payments.
Using electronic health record (EHR) systems, registries and other tools, analysts could crunch clinical data to see how one treatment protocol performed in relation to another. That data could also help make the case for reorienting payment incentives toward preventive care and away from the acute-care side of the ledger.
I’ve been thinking about how health IT and analytic tools might affect the government’s role as the health care payer and provider of last resort for the elderly and indigent in this country.
Certainly, health IT could help providers better understand the needs of those populations, which account for a disproportionate share of the country’s health care costs.
State and local health care agencies are already increasing their efforts in this area. According to a recent survey by the Commonwealth Fund, the greatest number of state e-health activities in 2007 occurred in the public health arena.
Those agencies most often relied on a basic health registry — a sometimes electronic but often paper-based tool for organizing information about people with a specific disease or condition. Those registries are the building blocks of the more sophisticated EHR systems and health information exchanges of the future.
One of the trendsetters in the public health IT field is Orange County, Calif. Officials there are using a Web-based system to improve the tracking and coordination of medical care for 25,000 residents who are impoverished. Many of them are also chronically ill and/or homeless. As the story in this issue of Government Health IT shows, the system arose from an interest on the part of emergency room physicians for better clinical and diagnostic data on poorer, transient patients.
Telehealth systems and services are also in high demand to aid in treating such patients. State and local governments — and state Medicaid agencies in particular — are at the forefront of using the technology. In fact, roughly half of state Medicaid agencies have telehealth services in place, according to the Commonwealth Fund study.
In the current excitement over health IT, the government is most often regarded as a standards-setter and regulator. But it’s important to recognize that public health agencies are often the only option for much of the country’s disadvantaged. It is in this area that government investment in health IT will be able to show some of its greatest returns and rewards.
Government Health IT presents Rick Friedman, director of the division of state systems for the Center for Medicaid and State Operations with the U.S. Department of Health and Human Services, in this recent eSeminar regarding how the federal Centers of Medicare and Medicaid Services is partnering with state Medicaid and health and human services officials to bring Medicaid into the digital age. Paul McCloskey, Government Health IT editor, moderates.
