Healthcare Information Technology — The Key to Unlocking the Door to National Reform
by Dr. Steven J. Kraus, D.C., D.I.B.C.N., C.C.S.P., F.A.S.A.
President Obama’s administration recently hosted forums on healthcare reform in cities across our country. I was fortunate to be included on the invitation list to the forum held in Des Moines, Iowa. The Iowa White House Forum on Healthcare Reform featured a panel of high-profile elected officials, including Senator Tom Harkin, Iowa Governor Chet Culver, South Dakota Governor Mike Rounds, and Nancy-Ann DeParle, who serves as the director of the White House Office on Healthcare Reform.
True reform is not just looking to pay for coverage of all Americans. If we only seek to pay the bills, we are simply expanding coverage for the uninsured with no true system reform
As one of the few selected to ask a question of the panel, I inquired about evidence-based practices and the role they would play in impending reform. I discussed how evidence supports that low back pain treated by a chiropractic physician is a best practice for its effectiveness and cost efficiency, but the challenge we face is having no way to communicate this conclusion to the broader healthcare community. The essential question: If we are to have true healthcare reform, how are we going to make information on best practices available, quickly and to all medical providers?
The answer: Through technology.
The Obama Administration is pushing to launch a reformed healthcare model by the end of 2009. Senator Harkin is leading much of the reform policy discussions and has announced his goal to establish policy rules by June. Senator Chuck Grassley, influential on the financial side of the healthcare equation, and Senator Harkin are committed to fulfilling the President’s bipartisan promise and are working aggressively toward these timelines.
Senator Harkin gave insight into his viewpoints, and what we might anticipate as a national model, when he used my inter-disciplinary clinic as an example at the forum. My clinic employs MD’s, DC’s, physician assistants, physical therapists and others, including acupuncturists. Senator Harkin’s belief is that we need integration and collaboration; healthcare professionals must come together and work as a team to deliver the best possible patient outcomes. He also indicated that we have a "sick care" system, rather than a healthcare system. In order to have a healthcare system, we must also focus on wellness and prevention, and not exclusively on those who are already ill. And finally, true reform is not just looking to pay for coverage of all Americans. If we only seek to pay the bills, we are simply expanding coverage for the uninsured with no true system reform. The goal for healthcare reform is to change how care is delivered, and much of that change will be supported by technology.
The forum attracted attendees from all facets of healthcare, including dentists, surgeons, Advanced Registered Nurse Practitioners (ARNP’s), chiropractic physicians, and more, and everyone is seeking to be integrated into this anticipated collaborative model. But, reform is not about racing to the front of the line and just being counted. Rather, it is about changing the method of selecting services, how we integrate patient choice and patient responsibility, and addressing physician responsibility for treating the whole person and not just the ailment that prompted the patient to make a clinic visit in the first place. Reform is about managing the total health of the patient and, ultimately, with the right technology and care plan, letting the patient heal himself.
Only those who demonstrate preparedness and an understanding of the true need for change will be taken seriously in reform discussions. In the current climate, preparedness is synonymous with technology, and chiropractic physicians who implement Electronic Health Records (EHR) are more likely to get the attention of the federal government and policy makers. Preparedness gives us influence and tells those leading reform efforts that we, too, are serious about participating in a changed system. In this situation, there is great power in numbers. The more doctors of chiropractic who adopt an interoperable EHR system, the more credit we will get for responding quickly to government imperatives on the front end, instead of waiting, like many others, until the last minute.
When we adopt this technology, it is absolutely critical that we select something more than a digital note-taking system. Such a program will not be sufficient to support the anticipated depths within reform. Does the system you’re considering assist you by offering alerts about non-compliant patients? Does the proposed system monitor the plan of care? Is there intelligence built into the technology to guide you, rather than just capturing information you enter? We can only improve care if we move to a digital system that works side-by-side with us, to share best practices, measure outcomes, and provide detailed patient information to other practitioners when requested. A true EHR program accomplishes this, and more.
The reality is that care will be managed jointly by the doctor and the patient, and technology that allows for the transfer of data back and forth provides guidance on best practices, and monitors information to provide valuable alerts and reminders which are key to helping the doctor better manage case load. Get the right technology now and be a player in early healthcare reform—the train has actually left the station, so catch up and get on board, before it’s too late.
Dr. Steven J. Kraus is CEO of Future Health, Inc., a company that partners with chiropractors to deliver a comprehensive clinic management solution, including fully-integrated EHR. Dr. Kraus is a recognized expert in building successful clinics, having developed and sold 18 practices of his own and provided strategic consulting services to more than 400 healthcare businesses. He offers leadership to numerous industry associations and currently serves as the Chairman of the Iowa Board of Chiropractic. Contact Dr. Kraus at
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