Over the past years, medical journals and legislators from Beacon Hill to Capitol Hill have discussed the “Massachusetts experiment” — the idea that, given our head start on health care reform, we tend to be a good litmus test for what parts of policy actually work. Mandates and marketplaces get recognized most often, but there are other parts of an improved health system that our state has also pioneered — the management of massive amounts of health information that has been digitized over the last decade.
Policy and advances in technology have made it imperative that clinicians spend a decent amount of time adopting digital patient records. If we expect doctors and their teams to create the digital versions of records that existed only in stacks of papers and folders for several lifetimes, then we must ensure the new information system is user-friendly and accessible to the people populating the database.
A functioning e-records system is immensely valuable, and the key to achieving an outcome focused model of care that relies on cross-practice coordination of patient care. Clinical teams deserve a system that reflects their efforts, from beginning to end. Simultaneously, patients deserve quick and easy access to their entire history at any moment in time. These rights can be easily realized with health IT. As public and private members of the health care field come together during National Health IT Week this week, we believe that Massachusetts — including our Partners HealthCare system and our peer providers across the state — once again has the right to lead the conversation on this key aspect of health policy.
To successfully transition from paper and fax-based systems, health care providers must evolve. Everyone needs to be in a digital frame of mind, and providers must commit to developing information infrastructures that can meet these standards. Despite not being an integral part of the mainstream discussion on health care reform, these health IT networks are crucial to the national law’s implementation. Massachusetts leads the way for the country in terms of building functioning systems, and federal offices rate the Commonwealth as significantly better than most states in terms of the adoption of digital patient records.
We know the financial results of these improvements. The Massachusetts eHealth Collaborative showed that outpatient spending costs rose at a slower rate among community health care providers that adopted electronic health records versus the organizations that abstained; the Massachusetts Medical Society reported that yearly increases on medical claim spending are now below 5 percent, and accurate electronic records are a factor.
But the state and nation have a ways to go before achieving fully coordinated care via health information management, and we’ve learned the challenges first hand. In fact, we recently launched a plan at Partners HealthCare to bring all our facilities onto the same network of patient records by 2017. Consider this project a case study on the difficulties that providers face across the country. Before we undertook the initiative, our two founding hospitals — Massachusetts General Hospital and Brigham and Women’s Hospital– had pioneered and developed their own patient record systems. As we grew and the sector matured into an advanced (and diverse) network of systems, it became more challenging for us to communicate between our own facilities. That meant that a patient’s record at one of the hospitals was not necessarily always as accessible as it must be – particularly in this new era of coordination. Scale this to the national level, with competing electronic health record vendors and regional hospitals, and you can imagine the massive complexities facing the American health care system.
If the Commonwealth wants to lead the nation again in health care reform, we must work hard to keep pioneering ways to connect care across our facilities. The only way we’ll get to coordinated care — caring for patients appropriately as they move in-and-out of various provider offices, clinics, hospitals and labs — physicians must have the accurate patient information at the right time.
During NHIT Week, we offer praise and admiration for those dedicated IT executives and doctors who have and are leading the digital transition at healthcare facilities across the country. For those who have yet to undertake the task, rest assured that the benefits are huge — and will keep all of our patients healthier.
James Noga is CIO for Partners HealthCare. Scott MacLean is Deputy CIO and Director of IS Operations for Partners HealthCare.