Mr. Halvorson Goes To Washington, Recap

Last Friday I wrote about George C. Halvorson's trip to Washington to give testimony to the Senate Finance Committee. Today, I would like to do a small follow up on that post.

Commentary and reporting on Mr. Halvorson's Senate testimony provided by Andrew Noyes on NextGov:

Kaiser Permanente CEO George Halvorson's testimony came as several legislative proposals intended to create a national system of electronic medical records are moving through Congress. Achieving such an overhaul would be daunting, and electronic medical records alone are not sufficient to provide optimal care, Halvorson said.

He called for a special support system that would analyze data from interconnected networks and give physicians prompts to support consistent care delivery and a stand-alone care registry for those Americans who will not have immediate access to integrated health IT. Once a fully computer-supported system is in place, the nation should aim to reduce asthma, congestive heart failure and kidney failure by 50 percent, he said.

Mr. Noyes then proceeds to provide capsule reviews of the responses from the Senate. From the cautious skepticism of Finance Chairman Max Baucus to additional testimony by CBO Director Peter Orszag, he provides a nice summarization of events.

Under Mr. Halvorson's guidance, Kaiser Permanente has become recognized as being at Leading Edge of Health IT, at least according to a piece in U.S. Insurance News a few weeks ago. His focus on the billions in savings, as well as the improvements in treatment it would usher in provide the impetus for his quest to implement IT solutions.

This is far from a new position for Mr. Halvorson. This interview in the San Francisco Chronicle back in 2003 show an almost prescient awareness of the direction we, as a country, have been going as the health care crisis gets worse with each passing month.

What we need is health care reform, and we need it now!

SOURCE: "Panel weighs challenges of adopting health IT overhaul " 07/17/08
SOURCE: " Kaiser Permanente on Leading Edge of Health IT" 06/23/08
SOURCE: "On the record: George Halvorson Kaiser CEO looks at the high cost of health care" 11/16/03
photo courtesy of mdu2boy, used under its Creative Commons license

George C. Halvorson and The Senate Finance Committee

On July 17, 2008, George C. Halvorson gave testimony to the Senate Finance Committee on the role of health information technology in improving health outcomes. The full text of his testimony is available in PDF format from the Senate Finance Committee's website.

If you would just like the highlights, but prefer to get them from someone a little more removed from Mr. Halvorson than we are, you should check out the post made by Condor over on the Searlings Got Plowed Blog. (I like to get multiple sources and perspectives so I feel compelled to offer them to our readers when I can.)

Here is one small excerpt that really grabbed me. Mr. Halvorson, in the course of detailing what Kaiser has already implemented in the way of electronic health records, shares the following letter received by his company. It's a letter that shows the human impact of these technological advances:

This last example was highlighted for me by a recent letter from a member that puts a human face on these statistics.

Early last year, I came to your facility to have a foreign body removed from my eye. I visited your Ophthalmology Department and your competent staff dealt with this minor emergency. What made this visit so meaningful was my interaction with your nurse after my visit with the doctor. In addition to giving me some after visit instructions, she noticed in the computer that I needed a mammography exam. I had been reminded before but I tend to be too busy to take care of my own health. This time the nurse was very insistent. She even made me an appointment so I could walk in and get the exam within the hour. Since I did not have to wait too long, I had the exam done that day. Well, they found a mass in my right breast and it was cancer. I have gone through chemotherapy and radiation therapy and today I am cancer free.

I am convinced that I am alive today because of your organization’s focus on my total health. My interaction with your entire health care system has been nothing but positive. I am especially appreciative to the young nurse who took the time to convince a stubborn old lady to take responsibility for my health.

Thank you for giving me many more years to thrive.

This letter describes a simple act by one of our nurses, but it was possible only because the nurse had access to that information, acted on it, and was part of an integrated health care system that encourages this series of events.

If you are at all interested in the application of technology in this fashion, I highly advise taking a look at the full text of his testimony. If it is food for thought you are looking for, this is a banquet!

Download PDF here.

SOURCE: "Testimony of George C. Halvorson Chairman and Chief Executive Officer Kaiser Foundation Health Plan and Kaiser Foundation Hospitals Before the Senate Finance Committee" 07/17/08
photo courtesy of Mr. George Halvorson

Congress Gets a Shot in the Arm

It would seem that the United States Congress is getting themselves mobilized to make an impact on health care. How much of these efforts end up being substantive and how many ephemeral is a question answerable only by the passage of time.

Ben Bernanke's recent statements about health care taking up a quarter of the federal budget were only one facet of the mobilization beginning on several fronts within those hallowed halls.

Sens. Ron Wyden (D-Ore.) and Robert F. Bennett (R-Utah) are sponsoring the first bipartisan proposal for universal coverage to come out of the Senate. The proposal would scrap employer-based health insurance replacing it with a state-run system where insurance companies are mandated to offer basic coverage to all applicants and compelling those not covered by employer-based plans to buy in.

Tom Daschle has just released a new book in which he argues in favor of a Federal Health Board similar in structure to the Federal Reserve. This probably will be one of the thrusts of the legislation he is currently working on along with fellow Democrat George Mitchell and Republicans Bob Dole and Howard Baker. The four former Senate Majority Leaders plan to introduce their legislation in November. (For an in-depth interview about the book and Sen. Daschle's stance on health care take a look at the interview that he did with Ezra Klein for the American Prospect.)

Via The Washington Post:

"We have a broad consensus that we aren't getting nearly as much as we should for the money," said Mark B. McClellan, President Bush's former director of the Centers for Medicare and Medicaid Services who now heads the new Engelberg Center for Health Care Reform at Brookings. "There's an unprecedented level of agreement that something can be done and that something must be done."

Let us keep our fingers crossed and our eyes open.

SOURCE: "Writing New Prescriptions For Change" 06/17/08
photo courtesy of yanivba, used under its Creative Commmons license

5th Annual World Health Care Congress

A stupendous array of health care expertise is gathered in Washington, D.C., supplemented by the health care policy advisors for U.S. Presidential candidates Sen. Barack Obama, Sen. Hillary Clinton and Sen. John McCain. It's the World Health Care Congress, and as you might expect, George C. Halvorson is there.

From the press release about this morning's panel:

-- Hear the Presidential candidates' platforms for health care reform

-- Compare proposals to address universal coverage and the fiscal
stability of Medicare

-- Reactor panelists provide an in-depth critique by evaluating the
economic and social impact of Democratic and Republican proposals

Panelists:
-- U.S. Rep. Jim Cooper (D-TN), Health Care Policy Advisor to Sen. Barack
Obama

-- Chris Jennings, Health Care Policy Advisor to Sen. Hillary Clinton,
former Senior Health Care Advisor to President Clinton.

-- Thomas Miller, resident fellow, American Enterprise Institute for
Public Policy Research, Health Care Policy Advisor to Sen. John McCain

-- George Shutlz, former U.S. Secretary of State, Labor and Treasury, co-
author "Putting Our House In Order: A Guide to Social Security and
Health Care Reform"

-- George Halvorson, Chairman and CEO, Kaiser Foundation Health Plans and
Hospitals

Health care reform, universal coverage, Medicare woes, and a solid analysis of the positions taken by our current crop of Presidential candidates should make for a fascinating (and hopefully productive) gathering.

The listing above covers on the first panel of the day for this event, in addition to those listed above there is an extensive roll call of movers and shakers in the Health Care scene in attendance who will be combining their expertise:

• Michael Leavitt, Secretary, U.S. Department of Health and Human Services
• James Hagedorn, CEO, Scotts Miracle-Gro Company
• Delos (Toby) Cosgrove, MD CEO, Cleveland Clinic
• Denis Cortese, CEO, Mayo Clinic
• Greg Tullman, CEO, Allscripts
• George Halvorson, Chairman and CEO, Kaiser Foundation Health Plans and Hospitals
• Mack Banner, CEO, Bumrungrad International (Thailand)
• Sam Nussbaum, Executive Vice President and Chief Medical Officer, Wellpoint
• Thomas Miller, health care policy advisor to Sen. John McCain
• Prof. Hans Rosling, MD, PhD Professor of International Health, Karolinska Institutet (Sweden)
• Michael Howe, CEO, MinuteClinic
• Paul Speranza, Chairman, U.S. Chamber of Commerce, Vice Chairman and General Counsel, Wegmans Food Markets
  

Best of all, in my opinion, is the fact that you can stream MP3 audio podcasts of the featured speakers here. Look for Mr. Halvorson's podcast, "Reforming the Delivery of Care to Impact 85% of Total Health Care Costs." It just went live!

Today, I would like to close with a quote about the event:

"This is the largest gathering of health care providers, thinkers and experts anywhere in this world."
—Lee Scott, President & CEO, Wal-Mart Stores, Inc.

Let us hope this massive array of talent and expertise can help us find our way down this complex and emotionally charged path to effective health care reform!

SOURCE: "5th Annual World Health Care Congress Kicks off April 21 With Obama, Clinton, McCain Health Care Policy Advisor Presidential Health Care Agenda Forum" 04/21/08
SOURCE: "5th Annual World Health Care Congress- Podcasts"
photo: Screencap of WHCC Website

System vs. System: Canada and the U.S.A.

In a new Op-Ed for the Healthcare Financial Management Association, George C. Halvorson analyses the differences between the U.S. and Canadian health care systems as well as their attendent costs.

Americans are increasingly asking why the United States is the only western industrialized country that has not managed to achieve universal healthcare coverage for all of its citizens. They also are wondering why we don't learn from our neighbors to the north and move the current Canadian universal coverage approach south. That's an interesting and important question.

[...]

Most people who know that Canada spends less money on health care believe that the cost difference is almost entirely due to the lower administrative costs that result from Canada using a “single-payer” insurance model. Is that true? No.

The truth is that Canada now spends about $2,600 per resident per year less than we spend on healthcare costs in the United States because-very simply-Canadians spend less money on the actual purchase of care.

What follows is a lucid and detailed analysis of the various contributing factors including, but not limited to:

• The Canadian Pricing Model


• Prescription Drug Coverage


• Adminstrative Costs

There is much talk of the Canadian health care system in the media as more and more Americans are drawn to the health care reform debate. This article is a wonderful source of hard numbers for anyone who is interested in the Canadian aspect of the discussion.

SOURCE: "Understanding the Trade-Offs of the Canadian Health System" 10/17/07
photo courtesy of striatic on Flickr under its Creative Commons license

Digital Medicine

While the pros and cons of SCHIP dominate the news and the blogosphere, a quiet little press release snuck onto the web this morning offering news of advances in the field of electronic medical records (EMRs).

CNNMoney reprints the original Siemens press release:

Siemens Medical Solutions is fulfilling the demand for a workflow-oriented, patient-centric approach to healthcare with its Enterprise Document Management (EDM) and Soarian(R) Healthcare Information Management (HIM) solutions, which are helping healthcare institutions enhance patient care, improve patient safety initiatives, and reduce healthcare costs.

Why would this drive the costs of health care down?

Accessible from any location, EDM and Soarian HIM coordinate processes within and between departments, as well as tasks between users. With their Web-based intuitive user interfaces, the solutions host concurrent and multi- user access, helping to eliminate multiple trips by clinicians and patient financial services staff to the HIM department to access patient data. When patient charts are virtual, costs and time associated with chart storage and retrieval are reduced. Many EDM and Soarian HIM customers are seeing positive outcomes as a result of use at their facilities.

So....

Transparent and portable medical information, eh? Good idea, sounds familiar. According to the release the implementation of these digital sstems has driven down costs while improving efficiency and accessibility. Photocopying costs are a good example. The cost of making copies of medical records was reduced by $100,000 annually for CaroMont Health of North Carolina. and $45,000 for the Mountain States Health Alliance after the implementation of HIM solutions.

The release presents some specific examples on a case by case basis:

CaroMont Health has reduced the number of record requests by 30 percent, its record analysis by 50 percent, its medical records delinquency rate by 84 percent, unbilled accounts receivables by 50 percent and photocopying costs by $100,000 annually.

You can rest assured that we will be returning to this story when there is more to report.


SOURCE: "
Siemens Soarian Health Information Management is Widely Adopted by Leading Healthcare Institutions in 2007: Leading Healthcare Institutions Embrace Technology That Enables Free Flow of Patient Documentation Throughout the Enterprise
" 10/08/07
Image by George Williams

Medical Records on the Internet

The Wall Street Journal ran an editorial by digital diva Esther Dyson
having to do with health care reform. (Journal articles require
registration to view.)

Dyson begins with this announcement:

In a couple of months, my genome, my answers to a substantial health questionnaire and my medical records (as many of them as I can collect, anyway) will be posted on the Internet for all to see.

Ms. Dyson -- who has a stake in several health-related start-up companies -- is one of 10 pioneers who have agreed to participate in the Personal Genome Project run by Harvard University geneticist, George Church.

Dyson explains that there are privacy concerns about putting this much personal health information online, but she believes the benefits will be worth it.

In his book, Health Care Reform Now!, author George Halvorson makes similar claims to Dyson's about the potential benefits of having health records accessible on the Internet:

We are on the very edge of using the Internet to improve care in a great many ways, both with individual patients and with caregivers.... Caregiver[s] would not need to wait years to attend a seminar to learn [a] new technique.

How do you feel about having your medical information available on the Internet? Do you think it's a bad idea that will lead to abuse of data, or a good idea that will lead to better care?

We'd love to hear your opinion. Comments are open but moderated.

SOURCE: "Full Disclosure" 07/25/07
photo courtesy of FreeImages