Technology to Cure the System
Oct.18, 2006— -- Many experts say what America really needs to do to fix its ailing health care system is not spend more money but spend the money it already have more wisely.
But what does that mean?
One way to spend more wisely is to reduce administrative costs. Many hospitals in the United States have created programs to do that.
Pioneering a New System: Integrative Health Care
Partners Health Care is an integrative hospital network in Boston, Mass. Brigham and Women's Hospital and Massachusetts General Hospital started the network in 1994. An integrative health system is one that lets patients see a primary care doctor and other health care providers, like a social worker or physical therapist, in the same network.
All those doctors work together to care for one patient. We recently spent time talking to the doctors and nurses at some of the hospitals in the Partners network, and asked them what they were doing to change how health care is delivered in America.
One of the major initiatives that the Brigham and Women's Hospital has undertaken is switching from paper to electronic medical records.
"The electronic medical records are a tremendous aid, enabling me to take the best care of my patients. I have all the information at my fingertips," says Dr. Jessica Dudley, a Brigham and Women's internist.
Dudley can easily know whether her patient is also going to another clinic or to another hospital.
And when Dudley needs to review any test results or images, the pictures are all right in front of her.
"I can actually pull up the X-ray -- the real thing," Dudley says.
Improving Care With Old-Fashioned Technology
Doctors and nurses at Massachusetts General Hospital -- also a Partners hospital -- try to reduce costs by reducing the need for urgent patient care. That is, they want to tend to patients before more serious problems develop.
They do this in a rather old-fashioned way -- by picking up the phone and calling their patients to check in.
"Our goal is to have a team of doctors and nurses reaching out to patients in their homes regularly in order to prevent the kinds of events that result in having to come to the emergency room," said Dr. Timothy Ferris of the Institute for Health Policy at Massachusetts General Hospital.
"The patients appreciate the fact that we're regularly checking in with them -- we're not waiting for them to make that urgent phone call."
This kind of care management is only for the hospital's sickest patients, usually those who suffer from several chronic illnesses.
Mongan Makes Medicine a Team Sport
Partners wants to improve health care for all patients, not only for the sickest. It hopes to redefine the way doctors work together."We're trying to see if we can't bring a higher order of organization to our health care system, and I think that should be a model for what we have to do around the country," says Dr. Jim Mongan, president and CEO of Partner's Health Care. "Medicine is a team sport," he says.
Mongan says that the fragmentation of our health care system is one of its biggest problems. The philosophy behind Partners is that system can be consolidated.
"One of the major elements of integration is the electronic medical record. Now as opposed to 20 years ago, we have a tool that can actually bring doctors closer together," says Mongan.
The definition of a group practice used to be that the doctors practiced in the same office building. But Mongan is working to change that definition by building a practice in which all doctors work from the same electronic medical record and all have agreed on the same treatment and take the same approach to disease.
"An integrated system has the potential to deal with fundamental cost drivers in medicine in the United States, that is, the incredible degree of variation in medical practice from one geographic area to another, within geographic areas in medical groups themselves," Mongan says.
Lowering Costs Through Change
If Mongan can structure things at Partners Health Care "so that the variation in practice is decreased, we can save large amounts of money and we can attain higher quality."
Of course, change is never easy. "I think we're all appropriately nervous about a system that regimented. But the kind of current fragmentation we have in our current system is the other end of the extreme, and what we're hunting for is to have an appropriate place in the middle," says Mongan.
And we hope the appropriate middle place will be a place where more Americans have affordable access to the health care they need.
Dr. Tim Johnson interviewed Drs. Dudley, Ferris and Mongan as part of the ABC News series, Prescription for Change. The interview was recorded on Oct 11, 2006.