We have politicians in Washington DC, as well as all over the country, fighting with each other, and with ordinary citizens, concerning health care.

In this corner of the world we concentrate on one small sliver of healthcare – that is healthcare information technology.

Surprisingly, what we do in this small corner of the world is amazingly highly connected to what is going to happen with the other 2 trillion dollars per year.

It certainly sees as if implementing electronic health record technology could save a ton of money.  The studies show tens of billions of dollars in savings.  In my humble opinion, that is just the tip of the iceburg.

Can EMRs lead to better care.  Of course they can.  They can also lead to worse care, slower care, sloppier care, etc.  It depends entirely on the combination of user and technology.  However, again, the right technology in the right hands can greatly improve the quality of care provided to many if not to most patients.

So, where is the majority of that soon to be $2 trillion spent.  We all know that a large part, in fact a phenomenally large portion of the healthcare dollar goes to take care of people during the last 2 years of their lives.  No, I am not going to get into the subject, at this point in time, of whether this care should be rationed or not.  My opinion – well – like I said I’m not addressing rationing of care right now.

However, I am addressing how to take care of people whether it be in their last 2 years of life or otherwise, as efficiently (yes – you can translate that to as inexpensively) as possible.  Certainly standard conditions (diabetes, high blood pressure, hyperlipidemia, etc.) do not need rocket scientists to take care of them.

Yes – as the combinations of diseases increase in complexity, then more intelligent (and more highly connected) health care practitioners need to be involved.

However, home care with diagnostic equipment hooked up to patients, can save extraordinary sums of money.  And, this is just one small piece of the “let’s save money with EMRs” puzzle.

So, wouldn’t it be nice if there could be a closed system (Kaiser-Permanente for instance, but that’s probably too big for this concept today) and evaluate all of the costs for all of the healthcare for the participants of the system.

Then, spend a few dollars (okay a few hundred million – but that seems like chump change in today’s $2 trillion healthcare economy) and force all healthcare providers to have interconnected EMRs.  How do you do that?  Should be relatively simple if performed on a constrained scale.  Either you, as a physician, have a job or don’t have a job in the system.  If you do, then you are using an interconnected EMR.  If you don’t care to use it – then you just don’t have a job in the system.

A system such as this, with a few thousand patients, and a sufficient number of physicians, both general physicians and specialist physicians, should be able to evaluate the costs of care extraordinarily well.

I bet that over the course of a brief 12 month period of time it would be determined that there were extreme savings in the healthcare dollar.  Integrated care.  Integrated medical records.  Integrated systems.

Any one volunteering to take on this project?

In any case – that’s my thoughts for today.