American People's Online Health Summit

The Healthcare Superhighway: How Technology Can Pave the Way to Reform

It often takes decisive presidential leadership to tackle a significant challenge.  As a student of history, President Obama has spoken often about looking to his predecessors for guidance.  When it comes to modernizing healthcare through information technology, he has taken a page from our 34th President, Dwight D. Eisenhower.

In the mid-20th century when he envisioned a nationwide interstate highway system, Eisenhower faced many of the same problems that we face in building a modern, electronic healthcare system.  While a highway system had long been a dream, it was Eisenhower who made it a reality when he proposed, and then in 1956, signed the Federal-Aid Highway Act, beginning the construction of more than 41,000 miles of interstate highways.

Prior to the highway system, Eisenhower described the nation’s roads as “an appalling problem of waste, danger, and death.”  This is an apt description of healthcare today.  Presidential leadership can change this, and President Obama is applying the same lessons that Eisenhower did more than a half century ago to achieve success.

First, President Eisenhower made a significant financial commitment. In 1956, Congress appropriated $25 billion for highway construction, which was a vast sum of money considering that total federal spending in 1956 was $70 billion. Hundreds of billions of dollars were eventually spent, making it one of the nation’s highest priorities.

President Obama will invest $20-30 billion to put information technology in the hands of doctors and providers.  The primary vehicle for this investment is through incentive payments from Medicare or Medicaid—more than $60,000 per physician—for the “meaningful use” of certified technology.  This will tie incentives to clinical performance measures.

Second, President Eisenhower created an interconnected system. One of the most important components of the highway system was its adherence to uniform standards of construction. According to the Federal Highway Administration, common standards included 12-foot lane widths, standard shoulder widths, a minimum of two travel lanes in each direction, and speed limits. This avoided each state building their own highways with their own unique specifications. They built a true ‘system.’

We must do the same in healthcare. If billions are spent to equip doctors and hospitals with technology that cannot communicate with each other, we will have laid a lot of track that does not connect.  The administration is helping to narrow the technology standards or specifications of how to exchange electronic information. 

Third, President Eisenhower created a true collaboration between the private sector, states, and the federal government through highway construction.  Even though the federal government paid 90 percent of the costs of building the highway system, the states were responsible for managing the construction, and the private sector did the actual work.

Building upon the leadership and progress from the Bush Administration, President Obama has made public-private collaboration a cornerstone of his efforts.

Eisenhower’s leadership created a wave of productivity and prosperity that we continue to ride today. It opened new markets through interstate commerce, created a national sense of community, brought the modern world to rural America, enabled families to move and travel over long distances, and drove innovation from coast to coast. We can experience that same level of transformation in healthcare through information technology. 

With even more difficult challenges upon us, this must be the first of many priorities where Republicans, Democrats, and Independents can join together to solve the problems we face.  It has happened before, and it must happen again.  Our country and our future depend on it.

Tom Daschle is a former U.S. Senator from South Dakota and former U.S. Senate Majority Leader.  Newt Gingrich is Founder of the Center for Health Transformation and former Speaker of the House of Representatives from 1995-1999.

How do we address the issues of time, connectivity, and sharing of health information in a 21st century intelligent health system?

In today’s connected world, the ability to electronically move clinical health information in a private and secure manner between disparate health information silos is now possible.  The technology available can create secure, interoperable networks amongst legacy systems to achieve delivery of health information from multiple sources at point of care to enhance the quality, safety and efficiency of care delivered.  The use of such a system can improve the coordination of patient-centered care while at the same time facilitating the reduction in healthcare spending and achieving improved health outcomes.  Moreover, the ability to aggregate de-identified health data for the purposes of public health surveillance offers great opportunity to improve the health of targeted populations.  The opportunities to improve healthcare quality and cost reduction afforded by health information exchange (HIE) systems and the use of electronic medical records is now being driven at the federal level through a variety of funding opportunities created in a section of A.R.R.A  2009 known as the HITECH Act (Health Information Technology for Economic and Clinical Health Act).

The Nebraska Health Information Initiative (NeHII, Inc.) is a Nebraska, 501(c)3 not-for-profit corporation, whose purpose is to provide Nebraska a statewide health information exchange (HIE).  The infrastructure for the HIE is provided by NeHII’s vendor partner, Axolotl. Implementation of the HIE, now in its statewide expansion phase, has met the mission of providing a private, secure, network for health information exchange, thus allowing the acquisition of disparate sources of health information at point of care.  Information currently available through the exchange includes lab and x-ray reports, clinical notes, medication history, allergies, demographic and eligibility data for those with coverage through BCBS Nebraska (currently the only payer participating in the HIE).  Secure exchange of health information remains the top priority to protect the integrity and confidentiality of the data.

As a full-time practicing, board certified neurologist, I have seen the benefits and values of HIE in clinical practice.  Without question, the ability to aggregate a patient’s health information from disparate sources at point of care enhances the quality, efficiency, and safety of the care I’m able to provide.  Moreover, the HIE has cut down the administrative task and time to obtain pertinent health information.  From the patient’s perspective, the HIE allows for improved coordination of care, greater efficiency in the delivery of care, not to mention being able to reduce unnecessary/duplicative testing.  The use of health information technology (HIE and EMR’s) is not about the technology itself, but rather using the technology to meaningfully use health information to achieve higher quality, more cost effective and safer care for our patients.  Lastly, only through the use of information technology can the increasing requirements for health data reporting be met.

For more information on NeHII, Inc., visit www.nehii.org.

Harris A. Frankel, M.D., is President of Nebraska Health Information Initiative (NeHII, Inc.).

Reducing Costs With Improved Efficiency

An essential part of any health care reform is finding ways to reduce health care costs by improving efficiencies without sacrificing patient care.  Health Information Technology (HIT) offers us a way to achieve both.    

A large contributor to high costs is the massive amount of money the healthcare industry spends on paperwork for Medicare and private insurance billing.  There have been studies that show upwards of 21 to 31 percent of all the money we spend on health care in the U.S. is spent on paperwork and regulations.  Talk to your doctor and hospital about how many people they must employ to fill out forms, and you will be amazed.

HIT provides us with a method to reduce the burden and duplication that shuffling paper imposes on doctors and hospitals.  However, an important part of implementing HIT centers on the interoperability of digital health records from one hospital to another.  I believe the simplification and standardization of forms would go a long way in aiding this process.        

I have introduced a bill that establishes a Commission on Billing Codes and Forms Simplification that is tasked with working with Medicare and the medical community to standardize and simplify billing practices while protecting patient privacy.  The goal is not a federal mandate to use a certain form but an industry standard that would be widely accepted.  The Commission would also study electronic forms and billing practices with the same goals in mind.  This measure takes a practical approach by establishing pilot programs to work out the details with doctors, insurance companies, and government agencies before system-wide changes are implemented.

Congressman Mac Thornberry became a Member of Congress in 1995 and first introduced the “Health Care Paperwork Reduction and Fraud Prevention Act” in 2001.  He has introduced four other health care bills in the 111^th Congress.

AMERICAN PEOPLE'S ONLINE SUMMIT

Center for Health Transformation

 

An ongoing, online Summit with the American People to discuss solutions to transform our country’s healthcare system.

 

Featured topic today Wednesday February 24, 2010

 

Health Information Technology: Saving Lives and Saving Money: protecting privacy while developing and delivering effective, efficient, personalized health and healthcare

Paper Kills 2.0: Using Health Information Technology to Save Lives and Save Money

 

Think of the first time you saw an iPhone in action.  Or the first time you browsed the Internet or the first PC you bought.  What did you think?  Most were probably blown away.  We intuitively knew that we held something transformational. 

 

What do you think when you see a paper medical record?  Rather than the excitement of innovation and progress, it’s typically something like, “Do I really have to fill this information out again?”  And that’s just the convenience factor.  Most of us are unaware of the price we pay for both lower quality care and higher costs.

 

For these reasons and more, it is essential that we move healthcare into the 21^st century through health information technology. The benefits are clear.  Updated, accurate, and comprehensive patient information at the point of care will prevent medical errors and will allow physicians, nurses, and providers to make better, more informed decisions.  Electronic access to information will reduce duplicative and unnecessary tests and treatments.  Automating cumbersome, manual processes will streamline workflow, eliminate inefficiencies, and lower costs.  These are facts.

 

The Obama administration will invest tens of billions of dollars to get modern tools like electronic health records into the hands of doctors and other providers. 

 

Will it be enough?  What are the solutions that ultimately get the 96% of physicians who don’t currently use an advanced electronic medical record to adopt and “meaningfully” use one?  What are the solutions that will ultimately lead to a modern, electronic, interoperable system? 

Paper Kills 2.0: How Health IT Can Help Save Your Life and Your Money

Paper Kills 2.0: How Health IT Can Help Save Your Life and Your Money is a 12-chapter collaboration edited by CHT vice president and national policy director David Merritt with a foreword by CHT Founder and former Speaker of the House Newt Gingrich and former Senate Majority Leader Tom Daschle.

 

 

Open is the New Economy and Will Lead to Greater Innovation

Think of the first time you saw an iPhone in action.  Or the first time you browsed the Internet or the first PC you bought.  What did you think?  Most were probably blown away.  We intuitively knew that we held something transformational. 

Remembering when the Palm Pilot came out in the late ‘90s, I couldn’t imagine anyone having a need for a device that provided more than the basics – phone directory, addresses, scheduler and date book, checklists and maybe notes. Now you can download an app for your iPhone called Shazam that identifies songs from music – one of some 100,000 Application offerings for the iPhone. Clearly, here to date, the iPhone platform has been quite remarkable. And it’s for this reason that I recently purchased the Droid phone for two of my kids; not an iPhone! The obvious question is ‘why not’?

I purchased the Droid because of a simple fact: Droid Phones are built on the Android Operating System. Google acquired Android, Inc. in 2005. The technology is a mobile device platform powered by the Linux Kernel. The technology license is Apache – a commercially friendly open source license. And for anyone who reads Chapter 9 in Paper Kills 2.0, you’ll understand why I think it’s a good investment and strategic in nature.

Apple’s business model typifies the old way of doing business. Their operating system is based on Darwin, the same proprietary operating system core that is found in the Macintosh operating system. The software development kits to write applications for the iPhone were first released in March 2008. Developers get a cut of any app that is sold through the Apple App Store BUT Apple controls all the distribution and the developer is prohibited from selling the application anywhere else. For anyone to use apps not offered through the Apple App Store, the users must change the device firmware through ‘jailbreaking’ to permit its use. Needless to say, this is frowned upon by Apple. Contrast the Apple model with the Google model that permits its Android operating system to be used on any mobile device. The software hooks are open and distribution is unrestrained. Certainly Apple has a great name and makes the sexiest devices on the planet but I think they’ll need to rethink their model. Gartner’s Ken Dulaney seems to agree as he predicts that the Android OS will overtake iPhone in global market share by 2012.

From where I sit, health information exchanges are the next wave of innovation that is going to change healthcare. If we do it right, these communication platforms for healthcare will spawn applications that we can’t even conceive of today. To promote this ‘new economy’, we must embrace openness and transparency. From a software development perspective, this is code-speak for ‘open source’. The healthcare industry can learn from the macroeconomic movements in other industries. Just look at Google. And as Gomer Pyle would say….”Shazam!”

Tim Elwell is Vice President of Misys Open Source Solutions (“MOSS”), LLC, leads the marketing efforts for Open Health Tools and is a Commissioner for CCHIT.

E-Prescribing as an HIT Success Story

Widespread health information technology (HIT) adoption holds great promise as a tool to enable dramatic improvements in healthcare but by any measure is a long way off.  There is a success story where real quality, safety, and efficiency benefits are being realized today by patients, physicians, payers, and pharmacies.  That success story is electronic prescribing.

Why is electronic prescribing an HIT success story?  For starters, a group of competitors in the private sector – payers/pharmacy benefit managers (PBMs) and pharmacy associations -- came together to create a collaborative enterprise to build and operate a national infrastructure to enable the electronic exchange of prescription information, now known as Surescripts.  Surescripts was founded on the principles of neutrality, transparency, interoperability, efficiency, collaboration and quality.  The government provided a standards development process, the National Council for Prescription Drug Programs (NCPDP), to ensure that as this infrastructure was built, standards are in place to govern the exchange of prescription information to allow for interoperability and scalability.

Fast forward ten short years and we have more than payers/PBMs providing prescription benefit, formulary and prescription history information on more than 2/3 of the U.S. population to 160,000 physicians and other prescribers using 200+ electronic prescribing and electronic medical record systems sending prescriptions electronically to more than 85% of the nation’s retail pharmacies and major mail order pharmacies.  More than 70% of those physicians are doing e-prescribing through a full electronic medical record and are well on their way to achieving meaningful use.

The growth of e-prescribing has been accelerating rapidly in the past few years and is likely to continue.  Our nation’s pharmacies and payers/PBMs are to be commended for their leadership in making this possible.  Many, many organizations and individuals have worked hard to make e-prescribing the success it is today.  Much work remains to bring this to mainstream adoption however the lessons learned can and should be applied to accelerate the broader adoption of health information technology.

Kate Berry is the Senior Vice President of Market Development for Sure-Scripts, which is the country’s largest electronic prescribing network. The Surescripts network is used every day by thousands of prescribers across all 50 states to electronically access prescription information and route prescriptions. Ms. Berry is also the Executive Director of the Center for Improving Medication Management, which helps physicians and patients optimally use technology to improve medication approval, prescription, and use.

Why Paper Medical Records Make Me Angry

Even as a 12-year old I understood that access to a personal computer represented a profound societal change. I remember explaining to a puzzled uncle that, in the past, those who understood the law had the power, while in the future power would go to those who understood technology.

    In graduate school, I read about Tim Berners-Lee, the inventor of HTML, and the first browser-editor called the WorldWideWeb. It was clear to me that this was going to change everything. I was going to witness the democratization of information.
 
    My father is a physician and nearly half my family are clinicians of some sort or another. The applications of this technology to saving lives were obvious to me. And yet, I often feel like I am bashing my head against a wall.
 
    In the 1990s I demonstrated a hand-held, physician-prescribing tool that allowed a physician to create a prescription. This prescription was automatically screened against a battery of drug utilization reviews, printed for the patient or electronically transmitted to a pharmacy. The system would even advise the doctor regarding the drug’s status with respect to the patient’s drug formulary. “But,” the doctor said, “I can write six prescriptions a minute on paper – I can only write 4 with your gadget.” He proceeded to prove his point by writing 6 completely ILLEGIBLE prescriptions in one minute.
 
    “Save me time or money, preferably both” is the message that every technology vendor gets when dealing with physicians.  I understand that physicians feel like victims. I understand that Managed Care has ruined their quality of life, and I have first-hand experience with the onerous consequences of defensive medicine; but, physicians remain one of the most powerful constituents in America. Hospital Boards have been known to berate CEOs for not spending their lunch-hour in the physician lounge rolling out the red carpet; hospital financial viability is threatened by the admitting behavior of only a few dozen surgeons. “Physician affinity” is now a hospital, self-defense buzz-word.
 
    When I lived in Chicago I had two doctors on the same floor of Northwestern Hospital. One used an EMR and had my chart at her finger-tips. The other, my primary care physician, did not. He needed two days to get my chart which, by the way, was stored just a few floors below. It was hard for me to accept that my chart being two-days away represented the best care for me.
   
    What I think about when asked to fill out reams of paper in a physician’s office is instead of hearing “save me time or money” I would like to hear “help me protect my patients” or “double check my numbers” or “let’s make sure my patients are educated”.  

    Paper kills.  Physicians are in the business of saving lives.

    When will I hear physicians demanding life-saving, mistake catching, outcomes supporting technology? When that day arrives, and I’ve dedicated my career to making sure it does, the 12-year old in me will be happy.

Jim Rosenblum is the Executive Vice President of Products and Chief Technology Officer for StatCom. Rosenblum brings extensive software development and healthcare solution leadership experience to StatCom. He is focused on defining StatCom's product strategy and development, as well as scaling the organization and its processes to support the company's growth. Rosenblum has a MS and is a Certified Professional in Healthcare Information and Management Systems (CPHIMS).

“I’ve learned more about my cancer over the past three days than ever before.”

We often hear similar comments from patients who arrive at our hospitals for evaluation and treatment. Why? State-of-the-art treatments combined with scientifically supported complementary therapies delivered by a multidisciplinary care team play a key role. So does health IT. Our robust digital platform – including a comprehensive, patient-centric electronic health record system – helps patients feel more informed and empowered as they wage the war on cancer.

Our system-wide EHR enables physicians and clinicians to spend more time explaining conditions and treatment options to patients, ultimately helping patients make better informed decisions about their care, among the most important they’ll make in their lives. Part of Our Promise at Cancer Treatment Centers of America (CTCA) is to empower patients and their families through clear information and data based on their individual needs. That information must be available when needed, where needed, in an understandable format, and complete with controls to ensure human errors don’t harm patients.

Better patient care is precisely the reason we began an aggressive implementation of our EHR system in 2006. We now serve cancer patients at four fully digital hospitals. We’re also excited to introduce a patient portal which will further put patients in the “driver’s seat” by providing them with direct access to the EHR and their data.

We discuss how the stimulus money provided in the American Recovery and Reinvestment Act of 2009 will eventually lead all hospital systems to switch to EHRs in our chapter of Paper Kills 2.0. If they don’t adhere to the mandate, there will be penalties. But more important than complying to regulations, hospitals everywhere should comply because it is the right thing to do for patients.

Patients like Maria Milam who experience firsthand the value of technology like electronic health records. In Maria’s words, “No one is running around looking for your records like they would be if I were in a regular healthcare system. It makes the experience more efficient and gives me more confidence.”

Chad A. Eckes joined Cancer Treatment Centers of America in 2005 as chief information officer. He leads an IT team focused on providing innovative technology solutions that improve patient care.

Pieces of the Technology Puzzle

Electronic health records (EHRs) are only one piece of the technology puzzle needed to get the health care system moved into the 21^st century. Fundamentally we must improve communication and sharing of information between everyone involved in a patient’s care, including primary care providers, specialists, pharmacies, hospitals, family members and the patient. We also need to improve access to care. We know that our country is facing a shortage of primary care providers, nurses and other critical health care personnel. Specialists are concentrated in large urban centers and are frequently inaccessible by residents of small towns or rural communities. EHRs alone will not address these problems.

Another valuable technology is telehealth, which allows patients to see and talk with members of their health care team whether they are across the town or across the country. We are a visual species – just look at the dramatic growth of YouTube, webcams and other devices for sharing images. Telehealth bridges physical distance between providers and patients unlike any other technology. When combined with interoperable electronic medical records that allow all relevant data about the patient’s health status to be shared, the power of telehealth is unsurpassed, as can be seen in some of the work of Spokane, WA-based Northwest TeleHealth at www.nwtelehealth.org.

As our country invests billions of dollars in modernizing the health care system, we must be careful to not fixate solely on EHRs. Thoughtful, synergistic planning and utilization of telehealth along with EHRs will truly make a difference in patient care.

Nancy Vorhees is the Chief Operating Officer for Inland Northwest Health Services, a non-profit organization providing shared services to hospitals and physician offices. Ms. Vorhees is responsible for a large regional telehealth system, a community health education program, and the region’s major air ambulance service.

Make Technology Useful and Useable

There’s a simple solution to getting anyone to adopt new technology – make it useful and useable. Useful means that the technology provides some advantage, maybe by saving money, creating a more efficient work environment or producing better results. Useable means that it makes sense to the user, is not overly cumbersome, and the costs aren’t higher than the perceived value.

Unfortunately many physicians in this country are not convinced that electronic health records (EHR) meet either of these criteria, let alone both. They are acutely aware that implementing an EHR is an expensive and potentially risky proposition. There are many stories of failed implementations or “successful” implementations that have resulted in unhappy users. EHRs can be very complex and difficult to use, requiring a change in office workflow and ultimately a change in the way a physician practices.

Rushing to dump EHRs into hundreds of thousands of physician offices may cause more pain than gain. If a physician is not really ready for an EHR and if the office staff haven’t been adequately prepared for the changes that the EHR will bring, the net results can be confusion and anger. An EHR that is used reluctantly and without thought to anything outside the practice is not going to contribute to a modern, electronic interoperable health care system. 

Ideally EHRs will evolve over time to become more like smart phones, so that physicians will find them both useful and useable. In the meantime, physicians need better ways to implement and run the current crop of EHRs so that they are successful and create value. Increasingly physicians are turning to shared service providers that operate the EHR on the physicians’ behalf, providing all implementation and support. Inland Northwest Health Services (INHS) is a leader in developing this model and has demonstrated what a dramatic difference it can make for physician offices (www.inhs.org). Unless some thought is given to how EHRs are used in physician offices, and not just how they are purchased, the huge federal investment in this technology will be a waste of money.

Jac Davies is Director of Northwest TeleHealth, Regional Outreach, and health@work for Inland Northwest Health Services.  Ms. Davies is responsible for managing a large regional telemedicine network, providing continuing education and support for rural healthcare providers, and promoting employee wellness.

The Big Disconnect

It’s difficult to summarize the Nebraska Health Information Initiative (NeHII) implementation into words in a blog post.  How does one describe an professional career that was divided in the middle by a deep dark chasm of disconnects?  My first life was spent as a registered nurse in high risk ever changing departments:  float pool, ED, OR, L&D etc.  I was reminded on a daily basis of the decisions that were made in the course of treatment based upon incomplete, partial information confirmed or disputed by the patient, who hopefully understood the questions we were asking and the impacts of the decisions we were making.  Needless to say the experience left a permanent mark, but it also inspired passion for change.

Through all this I was drawn to the wonder of technology, and in my second career as an entrepreneur of a technology consulting company, I caught wind of a project to implement health information exchange across the state of Nebraska.  I was hooked.  Suddenly a bridge appeared to cross the chasm (albeit perhaps a rope bridge with obvious threatened unraveling intertwines), but nonetheless a bridge and there were few who understood the challenge.

How do you influence change in an industry that embraced paper and redundant processing while asking the patient to confirm certain facts about their medical history?  How do you convince professionals who want to protect their patient’s personal health information that an electronic exchange is more secure than the paper found or not found in stacks and rooms of charts?  The technology for health information exchange is proven, but the politics of implementing HIE are nothing to be taken lightly.  It is a lesson I have had the pleasure of learning time and time again as we have moved through the pilot and now implementation of a statewide HIE for Nebraska.

In my next post, I’ll talk about my life as an entrepreneur and how I called on the skills, or should I say, nerve, that goes along with that label.

Deborah Bass is the President and Chief Executive Officer of Bass & Associates, Inc., which she helped found in response to the demand for business and information technology consulting services. Bass & Associates currently employs more than 85 IT consultants offering IT services in an eleven-state region. Ms. Bass has received numerous awards, including national recognition as the Goodwill BAC Member of the Year in 2000. She also serves as the Interim Executive Director of NeHII.

Calling All Skills

One of the most valuable skills as an entrepreneur is the inane ability to persevere and look for alternative routes to desired results.  This was a talent that was called upon on numerous occasions in the early days as we worked to achieve stakeholder buy-in for the project and then financial support.  We met with major employers who had contacts on boards of directors who were later to cast votes in support of the NeHII pilot project.  We were also benefited by the CEOs of the health systems who were committed to doing what was right for the patient and discounted the competition that occurs when health information is owned by a closed system.  They were willing to compete using the free flow of information and achieving improved standards of care at competitive pricing.  They were the real visionaries!

Even with the backing of the pilot participants and the tremendous success of the pilot project, NeHII was still faced with the resistance of out state stakeholders who remained defiant to the Big Gorilla from Omaha telling them what to do again.  We are continuing the battle – and it is a battle, but gradually, we are winning them over one by one as the success stories are told and the believers begin to multiply.  Who are the believers?  The physicians – they are telling the story of what this means to their patients and their ability to deliver improved safety and quality of care.   They are leading the charge and urging, if not demanding, health systems join in the effort.  The implementation of HIE will always be a grassroots and painstaking effort, but it is as rewarding as the challenge.  At the end of the day, I can rest assured something great and memorable was accomplished today.  I can sleep knowing the next day will bring a new round of challenges and small victories that make the journey so worthwhile.

Deborah Bass is the President and Chief Executive Officer of Bass & Associates, Inc., which she helped found in response to the demand for business and information technology consulting services. Bass & Associates currently employs more than 85 IT consultants offering IT services in an eleven-state region. Ms. Bass has received numerous awards, including national recognition as the Goodwill BAC Member of the Year in 2000. She also serves as the Interim Executive Director of NeHII.

Real Reform Through Real-Time Health Management and Consumer Engagement

It’s ironic that while there have been so many advances in medicine—robotic-assisted surgery, the cloning of embryos, the mapping of genomes—our health delivery model has remained essentially the same.  In no other industry do we basically “do it” the same way we “did it” years ago. 

Unfortunately, the consequence of our inability to change is reflected in the high price we pay for healthcare.  Today, Americans spend $7,290 per person a year on health — more than double what any other developed nation spends. 

If we are to significantly impact healthcare outcomes and costs, we cannot continue to do it the same way we did it years ago. Healthcare IT must deliver the same real time, real life data upon which every other industry in America – from sports to transportation to mobile devices – runs.

At its core, healthcare is a data issue -- who has it, who has access to it, when do you utilize it and what can it tell you that you didn’t know 10 minutes ago.  Vital to this is the movement of data across the continuum of care, from the physician’s office to the patient’s home and anywhere in-between.

To change the state of healthcare, we need a new framework that enables innovation, rewards experimentation, and ultimately drives value.  We need a health delivery system that is designed around real-time health management and consumer engagement.  This is what will allow us to realize the policy goals of providing increased access while maintaining fiscal responsibility and to deliver on the future – the promise of personalized medicine.

An authority on the intersection of technology, health and business, Peter Neupert is corporate vice president of the Microsoft Health Solutions Group, and previously served as president and board chairman for drugstore.com.