Wednesday, January 9, 2008
Today, the political debate over health care is divided into two camps. Some want to scrap the current system entirely and replace it with government-run health care. Others point to the long lines and high taxes plaguing Canada's government-run system and say it's wiser to make incremental improvements.
Most employers, who pay the lion's share of health care premiums, are in the second camp. Understanding that prevention is cheaper than treatment, many employers sponsor workplace wellness programs and encourage workers to eat healthier foods, get more exercise and stop smoking.
Another incremental improvement is a relatively new concept called "telemedicine." It relies on technology to monitor people's health at home or in rural hospitals, allowing patients in under-served areas to get the benefit of top medical experts without traveling hundreds of miles to a big medical center.
Patients are monitored via computer by trained specialists called "intensivists." The Leapfrog Group, an association of employers interested in reducing costs and dramatically improving patient safety, estimates that 54,000 people a year could be saved if every intensive care unit (ICU) in America were connected to monitoring systems managed by "intensivists."
The American Electronics Association (AeA) reports that a study by Critical Care Medicine found that electronic ICU monitoring reduced costs by 22 percent in the first year. Patients were safer, as well. Hospital mortality declined by 27 percent, the length of stay in an ICU dropped by 17 percent, and time in the hospital fell by 13 percent.
In addition, remote monitoring can help doctors provide more accurate diagnoses by allowing them to see the effects of stress and other real-life factors on a patient's condition.
Remote health monitoring has a long history in the Pacific Northwest. Back in the 1960s, Washington hospitals helped NASA conduct research on how to track astronauts' vital signs from thousands of miles away.
Today, the Northwest Regional Telehealth Resource Center leverages the collective expertise of 33 telehealth networks in Alaska, Hawaii, Idaho, Montana, Oregon, Utah, Washington, Wyoming and US-Affiliated Pacific Islands to share information and resources. In addition, hospitals like Seattle's Virginia Mason Hospital are investigating the potential for remote surgery - robotic surgery that can be performed by a surgeon halfway around the world.
If telemedicine is so promising, why hasn't it been implemented nationwide? There are several hurdles that could be overcome if the political debate were focused on fixing our current system.
First is money. The investment needed to implement this new technology is huge. The government may have to provide financial incentives such as low-interest loans, grants or tax credits to health care providers, particularly in rural areas, to purchase, install and maintain the new telemonitoring systems.
As part of that effort, AeA believes the Federal Communication Commission should increase its investment in broadband telecommunications technology, which would expand the capacity to electronically monitor remote locations instantaneously.
Second is electronic medical records. The push to convert medical records to electronic files that can be securely accessed by doctors, nurses and medical technicians quickly is important. Converting the old paper-based rows of medical records is expensive and some providers are reluctant to convert.
The government could encourage electronic records by reimbursing costs associated with electronic conversion when it pays for Medicare and Medicaid.
Finally, focus on the fix. Elected officials need to focus on improving the current system - keep what is working and fix what is not - rather than grab for the next huge pie-in-the-sky scheme which puts government in control of our health care.
In many ways, our health care system remains tethered to a 20th century world. But things are starting to change. Around the nation, medical facilities are testing and implementing electronic medical records and telemedicine systems which will bring us in to the 21st century.
Politicians need to give technology and innovation an opportunity to work. They ought to encourage it rather than being poised to pounce on even the tiniest of snafus. Remember that as you listen to the candidates espouse their plans to overhaul America's health care system.
Don C. Brunell is president of the Association of Washington Business.