Executive Perspective

Removing blind spots in health care

| May 21 2014
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Inefficiency comes with a cost. In health care, that cost can be measured in two ways: dollars and deaths.

About 30 percent of health care spending in 2009 — roughly $750 billion — was wasted, according to a 2013 study by the Institute of Medicine. This was the result of unnecessary services, excessive administrative costs, fraud and other inefficiencies. The report also found that up to 75,000 deaths may have been avoided in 2005 if every state’s health care performed as well as the top performing state.

These statistics highlight the urgent need for system-wide reform.

We are making progress, beginning with the adoption of electronic health records. According to the U.S. Department of Health & Human Services, more than half of eligible U.S. doctors and 80 percent of hospitals now capture patient health data electronically. This is an improvement since 2008. Just 17 percent of doctors were using electronic records then.

But even with better record-keeping, doctors are still left with blind spots. Most electronic records today are mere filing cabinets. While this is an improvement over paper files, many electronic records are not connected to other sources of patient health information. This leaves doctors with an incomplete picture.

To improve patient care and lower the overall cost of care, doctors need access to three types of information:

  1. Clinical data
    Currently stored in several systems, including electronic records
  2. Claims data
    From payers like Aetna — to show all the care a patient received
  3. Evidence-based medicine
    This highlights the care options so doctors can make informed decisions about the diagnosis and treatment of individual patients.

Having access to this information makes it possible to:

  • Coordinate patient care
  • Reduce duplicate tests and procedures
  • Better identify treatments based on the evidence and patient health history
  • Document improvements in patient care quality and efficiency

In theory, connecting health care data will also lower costs by spotting both fraud and unnecessary procedures. And of course, keeping doctors and hospitals better informed about patients’ medical needs is better for everyone.