Can Health IT Improve Medical Care?
About This Event

The U.S. health system is drowning in paper, and we are all paying for it in higher costs, less effective care, and medical errors. What has held back the adoption of health IT? How realistic are the hopes that health IT can promote delivery of high-value health care? Will the Listen to Audio

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$21 billion for health IT in the stimulus bill jump-start progress in this area?

Addressing these and other questions will be Leah Binder, CEO of the Leapfrog Group, a consortium of major employers and large private and public health care purchasers, who will discuss the group’s recent evaluation of how well hospitals have implemented their computerized medication systems, and Joseph Swedish, president and CEO of Trinity Health, a national network of hospitals and health care services, who will describe Trinity's experience implementing electronic health records in its facilities. Responding will be University of Minnesota professor Stephen Parente, director of the Medical Industry Leadership Institute, and University of Texas professor Benjamin Sasse, a former assistant secretary for planning and evaluation at the U.S. Department of Health and Human Services. AEI's Joseph Antos will moderate.

In the closing keynote address, David Snow, chairman and CEO of Medco, a leading pharmacy benefit manager, will discuss opportunities to build on existing health information systems to identify more effective treatments and improve the overall quality of care.

Event Summary

Can Health IT Improve Medical Care?

WASHINGTON, MARCH 23, 2009--Wider use of health information technology offers the promise of more effective treatment and greater efficiency in our health system. President Barack Obama's health plan includes a mandate for greater computerization of health information, and on March 20, he appointed Harvard's David Blumenthal to be the national health information technology czar, overseeing the $20 billion in the stimulus bill for health IT. But meaningful health gains from IT will not be easy to achieve, experts said at an AEI conference on March 18.

Joseph Swedish, president and CEO of Trinity Health (which has implemented health IT systems in their hospitals across the country), pointed out that such systems do not produce results unless changes are made in the way health care is provided in the local community. "Plug and play engagement is not realistic," he cautioned. Implementation can be far more expensive than managers may expect. However, with more than 14,000 drug alerts issued by the automated system annually for inappropriate prescribing, he "believe[s] this outcome has definitely saved lives in some cases." Echoing Swedish's call for a realistic look at the cost of health IT, Leah Binder, CEO of Leapfrog, argued that poorly implemented health IT programs could decrease the quality of care and increase costs. Because businesses pay for a large percentage of health care in the United States, "it will be a tax on the business community if this is not done well."
University of Minnesota professor Stephen Parente agreed with Binder's concern that the Obama administration considers an issue as important as health IT to be "low-hanging fruit." Parente pointed out that very little data support the claim that hundreds of billions of dollars could be saved through health IT, although a few integrated health systems have reported favorable results. He argued that we should exploit a little-used reservoir of data to provide real-time feedback about the effectiveness of health IT programs on health outcomes: Medicare claims data. The University of Texas at Austin's Ben Sasse kept the spotlight on Medicare, rounding out the discussion on the complexities of health IT implementation. According to Sasse, the current fee-for-service reimbursement system provides no incentives for providers to improve their efficiency. If it was implemented ideally, better health IT could improve patient care and reduce payer costs, but it would disrupt provider workflow and trim their revenues. Sasse said that there is currently no business case for the exchange of patient information among providers, given the way health care is paid for today.
David Snow, chairman and CEO of major pharmacy benefits manager Medco, made the case for health IT as an important "building block" of health system reform. Political will is needed to allow the public and private sectors to work in tandem. He pointed out that health IT is a means to a better functioning system--the real objective of reform. Snow suggested that cost savings will be generated from the technology's ability to allow us to attack the real waste in the system: how we treat and manage chronic and complex diseases. Today, he said, Medco is using an already-wired pharmacy system to close the gaps in care, increasing both patient compliance and physician adherence to the standard of care. By aggregating data for 60 million patients, Medco is able to examine national trends and provide physicians with information that can improve patient care. To bolster this argument, Snow described the successes his company has already seen in the fields of diabetes and asthma management. He concluded with a hopeful note: "health care reform is about putting cards on the table so we can have meaningful change."


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Joseph Antos is the Wilson H. Taylor Scholar in Health Care and Retirement Policy at AEI. He also is a commissioner of the Maryland Health Services Cost Review Commission and an adjunct professor at the School of Public Health of the University of North Carolina at Chapel Hill. Mr. Antos's research focuses on the economics of health policy, including Medicare reform, health insurance regulation, and the uninsured. He is the editor with Alice Rivlin of Restoring Fiscal Sanity 2007: The Health Spending Challenge (Brookings Institution Press, 2007). Before joining AEI, Mr. Antos was assistant director for health and human resources at the Congressional Budget Office, and he held senior positions in the U.S. Department of Health and Human Services, the Office of Management and Budget, and the President's Council of Economic Advisers.

Leah Binder
is the CEO of the Leapfrog Group, an organization of major employers and other buyers of health care working to make great leaps forward in the quality and value of health care. Prior to joining Leapfrog, Ms. Binder was vice president of the Franklin Community Health Network, based in Farmington, Maine, where she oversaw operations for the system involving marketing, planning, and public health outreach. She also served there as executive director of the Healthy Community Coalition and Franklin Health Access. Previously, Ms. Binder served as senior policy adviser to New York City mayor Rudolph Giuliani, where she developed programs to improve care of the uninsured, among others. She began her career in health policy at the National League for Nursing, where she served as public policy director. Ms. Binder also has served on many local and state boards and civic and professional boards, including serving as campaign cochair for the United Way of Tri-Valley; president of the Maine Public Health Association; and chair of Maine's public health institute, the Maine Center for Public Health.

Stephen Parente is the director of the Medical Industry Leadership Institute and an associate professor in the finance department at the Carlson School of Management at the University of Minnesota, where he specializes in health economics, health information technology, and health insurance. He has served as a consultant to several of the largest organizations in health care delivery, including UnitedHealth Group, Blue Cross Blue Shield, the Centers for Medicare & Medicaid Services, federal and state governments, and medical technology firms. Mr. Parente is the principal investigator for an evaluation of consumer-directed health plans using claims data from large employers. He is also examining the productivity and cost impact of information technology investments in hospitals and has recently concluded several studies on topics including innovations from health savings accounts and medical banking technologies. Mr. Parente was a health policy adviser for the McCain 2008 presidential campaign and served as a legislative fellow in the office of Senator John D. Rockefeller IV (D W.V.) during the George H. W. Bush and Bill Clinton administrations' health reform initiatives.
Benjamin Sasse served as U.S. assistant secretary of health and human services from 2007 through 2009, where he led policy, planning, and research functions across the department’s eleven operating divisions, with a special focus on Medicare, Medicaid, and the Food and Drug Administration. He teaches public policy at the Lyndon B. Johnson School of Public Affairs at the University of Texas. His research looks at efforts to modernize payment systems in American health care, to eventually migrate from "paying for more" to "paying for better" in ways that will stimulate entrepreneurial innovation from doctors, hospitals, and adjacent industries. Previously, he served as a chief of staff in the U.S. House of Representatives and as the chief of staff of the Office of Legal Policy, the internal think tank of the U.S. Department of Justice. Mr. Sasse began his career at the Boston Consulting Group and has advised a wide variety of organizations at moments of strategic crisis, working with airlines, utilities, manufacturers, the Department of Homeland Security, the FBI, the Federal Bureau of Prisons, the government of Iraq, and a number of nonprofit and educational institutions.

David Snow, Medco's chairman and CEO, is a health care industry veteran, innovator, and entrepreneur who has created and implemented solutions to manage the rising costs of health care for thirty years. Mr. Snow joined Medco, one of the nation's leading pharmacy benefit managers, in March 2003 as president and CEO and became chairman in June 2003. Prior to Medco, Mr. Snow was president and chief operating officer at Wellchoice, Inc. (formerly Empire BlueCross BlueShield). Throughout his expansive career, he has served in executive leadership roles for several companies, including Oxford Health Plans; American International Healthcare, Inc.; and U.S. HealthCare, Inc. He also cofounded and served as president and CEO of Managed Healthcare Systems, Inc., which was later renamed AmeriChoice.

Joseph Swedish has been the president and CEO of Trinity Health since December 2004, where he has focused on transforming health care delivery through improved clinical and business processes and expanding access to the growing population of underinsured patients through an expanded community benefit ministry. Mr. Swedish has thirty-five years of diverse senior executive operations experience in both investor-owned (as the East Florida division president for the Hospital Corporation of America) and nonprofit health care systems that span faith-based and secular health care; university- and community-based academic medical centers; integrated delivery systems; and regional rural referral hospitals in the mid-Atlantic states, Florida, Colorado, and now seven states that encompass Trinity Health’s markets.
He is a fellow in the American College of Healthcare Executives. Mr. Swedish serves as a board member for the Catholic Health Association and the National Center for Healthcare Leadership and as chair of the Institute for Diversity in Health Management, an affiliate of the American Hospital Association (AHA). He is a member of the AHA Long Range Policy Committee and has served as a member of the AHA Regional Policy Board-Region 8. In 1999, he was elected chairman of the Colorado Hospital Association board of directors. Mr. Swedish was awarded the University Medal by the board of regents at the University of Colorado. In addition, he was recognized as the 2003 Ernst & Young Entrepreneur of the Year, Rocky Mountain Region, and was the recipient of the American College of Healthcare Executives Regents Award for Career Achievement.

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