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Another Voice: Information management is vital to improving care

By Peter Winkelstein

In his Another Voice column June 15, Dr. Paul Kuritzky expresses his dissatisfaction with current electronic health record (EHR) technology. Unfortunately, this dissatisfaction is common (though not universal) among physicians. Columnist Charles Krauthammer has gone so far as to state the belief that EHRs are driving many doctors away from the practice of medicine.

Health care today is undergoing tremendous change. There is universal agreement that we must improve the “value” of health care, meaning that we must improve quality while reducing (or at least containing) costs. In addition, we must improve patient satisfaction and the overall health of our communities. These goals (improved value, improved patient satisfaction and improved population health) are called the “triple aim.”

It is impossible to achieve the triple aim without good information management. As Robert Wachter pointed out in a March 21 New York Times article (“Why Health Care Tech Is Still So Bad”), “Health care, our most information-intensive industry, is plagued by demonstrably spotty quality, millions of errors and backbreaking costs. We will never make fundamental improvements in our system without the thoughtful use of technology.”

This thoughtful use of technology has enabled us to begin the transformation of our payment system for medical care from a “fee for service” model, where every care activity (procedure, prescription, office visit) is separately reimbursed, to a “pay for outcomes” model, where reimbursement is based on a good outcome. Such a system cannot possibly work without a way of measuring outcomes. Outcome measurement requires the careful collection and analysis of data, something that can only be achieved through the use of EHRs and related technology.

Technology is also enabling patients to participate more fully in their own care. I recently had some bloodwork done. In a very short time, I received an email notification that my results were ready to view on the patient portal, along with a note from my doctor.

Current EHR technology still has many flaws and inefficiencies. Nevertheless, information technology is the key to improving health care and achieving the triple aim. Those of us in the health care information technology field are acutely aware of the challenges and limitations of EHRs, but are striving to improve the technology in service of providing better health care.

We hope physicians will continue to work closely with us to find the best ways to care for our patients, their families and the community.

Peter Winkelstein, M.D., is professor of clinical pediatrics at the University at Buffalo, executive director of the Institute for Healthcare Informatics at UB and chief medical information officer at Kaleida Health.