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A Health Reform We Can All Support

Posted on July 6, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

If you’re like most Americans, you have a pretty strong idea of where you stand in the debate over healthcare reform. This has always been a hot button issue, but now attempts to repeal or remake the terms of the Affordable Care Act have heated things up further.

Is there any strategy that can generate a bipartisan agreement on these issues? Well, maybe. Buried in a Washington Post article on bipartisan reform, there’s an idea you’ll probably like. Bear with me for a moment and I’ll explain.

The piece, which was written by Harvard economist David Cutler, notes that there’s a few industry problems that nearly everyone recognizes, including the need to address the opioid epidemic, the importance of trimming medical pricing and costs and adopting strategies to slash healthcare’s high levels of administrative spending.

Not to dis a Harvard professor too much, but most of his piece lacks specifics. OK, great, we get that you’ve identified some overarching problems the healthcare industry must address. That’s fine. What about doing something other than saying “This house is on fire. Get a bucket of water!”?

Such vague pronouncements are part of why reform is so difficult; few experts seem to be willing to get down in the weeds and explain just how execute on their proposals. The pundit-ocracy and professors and think tanks are looking at reform issues from the 10,000-foot level – and there’s merit in what they do. But providers are on the battlefield fighting for their lives, and theories don’t help them much.

Nonetheless, Cutler did list one cost-cutting measure that could actually be practical. He argues that developing uniform quality metrics all providers and health plans can use, as the current explosion of quality data demands is unsustainable.

Cutler argues that a government entity should manage the process of consolidating metrics, and even write regulations demanding that providers use the resulting standards. I, for one, think that this isn’t going to work, as the federal government doesn’t have a great track record in building consensus on health IT issues.

Still, if there’s a reasonable way to do so,  most providers would love, love, love to see somebody rid them of the hundreds of quality measures they must address and simplify the requirements to only those that actually impact quality. Who wants to deal with MACRA, Meaningful Use and its descendants, the Physician Quality Reporting System plus dozens of other data requirements? Hospitals and doctors are being quality-measured to death.

I know, I know, it seems unlikely that anyone could slash their way through thousands of standards and pick a winner. After all, the reason there are so many approaches is that no one is sure which one is best.

Can we at least agree that scaling back demands is critical? Yes? That’s progress. I’m not suggesting that there’s anything wrong with complaining non-stop about the quality metrics problem; in fact, given the burden these requirements impose, you’d be crazy not to protest. But it’s time to get real and figure out exactly what you want to do about the problem. Are you ready to demand change?

Australia Moving Ahead With Massive PHR Project

Posted on April 2, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Recently, I wrote a piece for this blog arguing that the PHR model was at a turning point — and didn’t hide my doubts that this approach had much of a future.

In response, one of our readers was kind enough to tip us off to a massive PHR project which had never shown up on my radar. Apparently, the Australian government is well into building the infrastructure to support a nationally-available PCEHR (personally controlled electronic health record).

The $467 million project, which is undergoing its second wave of testing and development, will make PCEHRs available to consumers by July 1, 2012.  Nine sites are running related projects, including:

*   A system making prescribing and dispensing data available to 2 million citizens and their providers

*   A project targeting data sharing among palliative care patients and clinicians

*   A site focused on improved health for a population of about 9,000 mothers and newborns

*   A consumer-oriented portal, serving chronically-ill patients, integrating patient-entered medical data into a “Health Book”

The PCEHR project comes as Australian health officials undertake a package of national health reforms, including efforts to increase access to primary care and a $20 billion investment in improving public hospitals.

While I still doubt that the current US approach to personal health records makes sense — who decided consumers would bother with a sort of “extra” set of records designed to make key data available in a poorly-defined emergency situation? — rolling out PHRs aggressively as a key component of a primary care-oriented national health reform makes a great deal of sense.

I’m eager to see how Aussie citizens respond next year when the PCEHR goes live.  If consumers are convinced that the personal record is the key to better health, I’m sure they’ll jump on board.