Are we looking to save jobs or create jobs?

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For many years, presidents and presidential candidates have touted the benefits of HIT.  Health Information Technology, they’ve stated, can save lives, save money, improve medical care, allow physicians to make more money (???) as well as many other benefits.

Most recently, however, there seems to be an issue regarding whether or not HIT will save jobs or create jobs.

For instance, two recent articles, apparently quoting president-elect Obama appear to have contradictory information.  From: we see: “To improve the quality of our health care while lowering its cost, we will make the immediate investments necessary to ensure that, within five years, all of America’s medical records are computerized,” and “But it just won’t save billions of dollars and thousands of jobs; it will save lives by reducing the deadly but preventable medical errors that pervade our health-care system…”

My interpretation of that latter sentence is that it will ‘save thousands of jobs.’  From my perspective, that is not job creation.

However, from the same week we have an article in CNN from

It states, in part:

“Doctors cannot spend hours and hours learning a new system,” said Castillo. “It needs to be a ubiquitous, ‘anytime, anywhere’ solution that has easily accessible data in a simple-to-use Web-based application.”

But highly skilled health information technology professionals are as rare as they come, and many IT workers will need to be trained as health technology experts.

Early government estimates showed about 212,000 jobs could be created from this program, but Brailer said there simply aren’t that many Americans who are qualified.”

Finally, we have: “In addition to connecting our libraries and schools to the Internet, we must also ensure that our hospitals are connected to each other through the Internet. That is why the economic recovery plan I’m proposing will help modernize our health care system – and that won’t just save jobs, it will save lives. We will make sure that every doctor’s office and hospital in this country is using cutting edge technology and electronic medical records so that we can cut red tape, prevent medical mistakes, and help save billions of dollars each year.” as quoted in 

So, we find that Health Information Technology, if implemented nationwide will both save jobs and create jobs.  Note that in this context ‘saving jobs’ means that employed people will no longer be employed, thus saving money…

I, for one, am very anxious to see how this works out!


PHRs: The Next Big Thing?

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Magazines and newspapers are spilling much ink over Personal Health Records (PHRs), the latest piece of IT that will fix healthcare. I asked my small-practice doctor a few weeks ago what he would do if a patient presented him with a PHR. Not much, he answered (first I had to explain what it is.) No insurer would pay him to populate the data and it isn’t integrated with his (limited) PPM system. The patient would be welcome to a copy of his medical records (for an exorbitant “handling & copying” fee) to populate the PHR himself, but good luck making out the doctor’s handwriting, medical abbreviations and terminology. If one had seen specialists, those separate records would need to be secured and entered as well.

The PHR hype is in full swing, and it will likely take a decade minimum for a majority of patients to have PHRs. I doubt most people will even look at their PHR even if they have one. Progressive insurers like Aetna offer members a pre-populated PHR based on claims data. In the long term, this will help Aetna improve care, reduce errors and lower costs. Follow the money and one will see the adoption path PHRs follow.

As with all technologies, the question of standards is arising with PHRs. AHIP has taken a good first step in creating a standard that is expected to be ready by December of ’08. The standard includes data set and portability requirements to take into consideration a person’s change in employers and health plans.

Some payors like Medical Mutual of Ohio and Anthem BCBS have PHRs that align with the AHIP standard. Time will tell how PHRs are accepted by consumers. Nationally, CCHIT, the Certification Commission for Health Information Technology, will be certifying personal health records (PHRs) next year. Criteria will be proposed in April, 2009, along with a comment period. Certification will officially start in July 2009.

CCHIT’s certification of EMRs met with mixed reactions early on, with smaller vendors crying foul over the $20,000 fee. Since then, it’s become a somewhat important stamp of approval in large enterprise purchasing decisions. This will likely happen with PHR certification as well.

Locally here in Massachusetts Blue Cross Blue Shield of Massachusetts partnered with Google Health to enable members to import their claims data into their Google Health profile. BCBSMA says that members with Google Health PHRs will be able to share data with healthcare providers who currently don’t have access to their data. Also, they can download medical records and prescription history from other connected providers.

By Shawn Whalen, SVP & Director, Healthcare IT Practice, Schwartz Communications