by Bill Copeland, Vice Chairman, U.S. Life Sciences & Health Care Leader, Deloitte LLP
Try to imagine not being able to read. Howard Wainer, an American statistician, poses this challenge to his statistics students when he teaches his introductory course. To him, the idea of statistics to those who learn it is similar to learning how to read or swim. He goes on to explain that, while it is difficult to learn these skills, once you do, you cannot imagine a time that you were unable to read or swim.1
Try to imagine health care without technology. No MRIs, X-rays or even stethoscopes. For me, it’s difficult to imagine—technology has brought the health care industry a long way. However, despite the massive investments many organizations have made on information technology (IT), it is not doing all the things we want it to do—systems do not talk to each other, and use of these systems for new analytic insights is just beginning.
Stakeholders across the health care system are working to correct this disparity. While there may be frustrations around Meaningful Use and challenges with adopting electronic health records, the support behind health IT continues to grow. Even with this support, however, challenges still remain.
My colleague Sarah Thomas and I recently had an opportunity to address some of the most pressing IT challenges facing the health care system. In June Senators Ron Wyden and Charles Grassley, who represent the Senate Committee on Finance, sent a letter to stakeholders from across the health care continuum asking for comments and feedback on the state of data transparency in the health care system.
Their request was backed by some eye-opening statistics:
- The amount of information that is stored digitally has grown from 25 percent to 98 percent worldwide since 2000
- Five quintillion bytes of digital data existed in 2003—as much is generated every two days now2
We responded to this request from Senators Wyden and Grassley by discussing two questions that are critical to the health care system:
How can the federal government encourage a “culture of interoperability”?
Interoperability is a patient safety issue. Some estimate that anywhere from 8-14 percent of medical records have information attributed to the wrong patient.3 In order for the health care system to move toward greater interoperability, advancements in technology are not enough—even with the unprecedented rate of progress that has taken place in the last decade. The federal government could inspire this culture of interoperability by:
- Offering incentives to providers and other stakeholders to agree upon and implement standards that are flexible enough to meet the broad scope of needs of individual stakeholders in the system
- Encouraging vendors (e.g., electronic medical records) to expose their data model and agree to use the same standards (both existing and future) for use in collaborations, roadmaps and coalitions related to interoperability
- Identifying and promoting the use of best practices to build interoperability into a system early in development
- Broadening Medicare and Medicaid incentives for health IT from technology adoption and use alone to include successful interoperability
How can the government encourage consumer engagement in health care?
Patients want their doctors to use health IT, but more can be done to advance patient engagement. Deloitte’s 2013 Survey of Health Care Consumers found that seven in 10 consumers say they would prefer a physician who uses health IT over a physician who does not.4 Mobile apps, telehealth and other nontraditional care delivery models are enhancing overall consumer engagement in health care, but more can be done to advance the consumer engagement movement in health care and capitalize on consumer interest. The federal government could lead the way toward greater consumer engagement by:
- Advancing more pilot testing in the area of telehealth to help ensure this evolving model of care does not introduce new sources of error into clinical processes
- Creating demonstration projects that reduce regulatory barriers to telehealth technologies and guide stakeholders on how to develop and refine telehealth programs to improve health outcomes and reduce costs by making care more efficient and convenient
- Driving reimbursement reforms to achieve quality outcomes against evidence-based standards through its role as both a payor and a provider
- Further incentivizing and setting the example for the use of value-based insurance design as a way to create incentives for consumers in Medicare Advantage and the private health insurance marketplaces to make health care decisions that are cost-conscious
The Deloitte Center for Health Solutions’ surveys have found system-wide discontent with health care. Consumers do not believe the system is providing value, nor is it meeting their needs.5 Employers are also looking for more: 52 percent want greater transparency around prices, and 46 percent want clear, accessible information about care provided by doctors.6 These findings suggest that there is great potential for new product ideas at the intersection of information technology and consumer demand for transparency.
My youngest daughter was born at the turn of the century, and incredible to me, cannot imagine life without computers or the Internet. The U.S. health care system could one day move to one in which my grandchildren can only picture the system as one where systems connect with each other and consumers use tools that help them find the highest value services, plans and providers.
Read the entire Health Care Current here and subscribe at: www.deloitte.com/centerforhealthsolutions/subscribe.
1 SAS Institute Inc., “Analytically Speaking – Interview with Howard Wainer,” http://www.sas.com/apps/webnet/webcast_viewer.htm?index=wc_jmp01sep14bc
2 Senators Ron Wyden & Charles Grassley, Letter to Stakeholders on June 12, 2014, http://www.finance.senate.gov/imo/media/doc/Wyden Grassley data transparency letter5.pdf
3 ONC, “Patient Identification and Matching Final Report” February 2014. http://www.healthit.gov/sites/default/files/patient_identification_matching_final_report.pdf
4 Deloitte Center for Health Solutions, “Survey of U.S. Health Care Consumers,” 2013
5 Deloitte Center for Health Solutions, “Survey of U.S. Health Care Consumers,” 2013
6 Deloitte Center for Health Solutions, “Survey of U.S. Employers,” 2013
Bill Copeland is the U.S. Life Sciences and Health Care Leader for Deloitte LLP and the sector leader of the practice's health plans group. Bill helps companies and governments better address the direct challenges and extended ramifications caused by new developments with ICD-10, electronic health records, health insurance exchanges and accountable care organizations.