Transcript: Commissioners Video
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408 >> THE BIGGEST BENEFIT TO
409 CONNECTING PATIENTS AND
410 INDIVIDUALS AND DOCTORS TO
411 HEALTH INFORMATION WILL
412 REVOLUTIONIZE THE LEVEL OF
413 KNOWLEDGE THAT PEOPLE HAVE ABOUT
414 THEIR OWN HEALTH AND WHAT
415 DOCTORS KNOW ABOUT THE PEOPLE
416 THAT THEY'RE TREATING.
417 >> THERE ARE PROBABLY MORE
418 OPPORTUNITIES TO DESCRIBE PLACE
419 AND TIMES WHEN I WANTED
420 INFORMATION AS A DOCTOR, AND
421 COULDN'T GET THE RECORD BECAUSE
422 IT WAS TIED UP, LOCKED UP IN
423 SOMEBODY'S OFFICE OR SOMETHING
424 LIKE THAT.
425 USUALLY YOU FOUND A WAY AROUND
426 IT, BUT THE PROBLEM, OF COURSE,
427 IS THAT WE CAN'T DO THAT
428 ANYMORE.
429 MEDICINE'S BECOMING TOO
430 COMPLICATED.
431 PROTOCOLS FOR SOME ILLNESSES ARE
432 SUCH THAT, IN FACT, IF YOU DON'T
433 HAVE THE INFORMATION AT HAND
434 WHEN YOU NEED IT, YOU REALLY CAN
435 HAVE PROBLEMS.
436 >> I THINK IN THIS INCREDIBLY
437 COMPLEX INDUSTRY THAT WE HAVE,
438 THERE IS JUST SO MANY
439 OPPORTUNITIES FOR MISTAKES.
440 THERE ARE SO MANY ERRORS THAT
441 CAN TAKE PLACE JUST BECAUSE
442 PEOPLE DON'T HAVE THE RIGHT
443 INFORMATION AT THE RIGHT TIME.
444 AND I THINK WE CAN TRULY MAKE A
445 SIGNIFICANT DIFFERENCE IN THE
446 LIVES AND HEALTH OF PEOPLE IF
447 WE CAN JUST GET OUR VARIOUS
448 COMPUTER SYSTEMS, OUR VARIOUS
449 DATA SYSTEMS TO CONNECT.
450 >> I THINK WE SEE THE BENEFITS
451 OF HAVING HEALTH INFORMATION
452 THAT'S ONLINE, THAT'S
453 ACCESSIBLE, THAT YOU CAN TAKE
454 IT TO THE DOCTOR WHEN YOU NEED
455 TO GET THERE, SO YOU'RE NOT
456 FINDING YOURSELF LISTING ALL
457 YOUR PRESCRIPTIONS AND ALL OF
458 YOUR SURGERIES OVER AND OVER,
459 NOT FILLING OUT NUMEROUS FORMS.
460 IT SIMPLIFIES YOUR LIFE IN MANY
461 WAYS IN TERMS OF GETTING IT
462 AROUND.
463 I EXPERIENCE THAT WITH MY OWN
464 PARENTS, WHO ARE BOTH DISABLED.
465 IN TRYING TO BECOME THE FAMILY
466 HISTORIAN AND GO FROM DOCTOR
467 TO DOCTOR WITH THEM, HAVING TO
468 RECOUNT THEIR HISTORY, HAVING
469 TO REMEMBER ALL OF THEIR DRUGS,
470 IT REALLY WAS OVERWHELMING IN
471 MANY, MANY INSTANCES.
472 AND I LOOK AT SO MANY OF MY
473 FRIENDS AND NEIGHBORS WHO ARE
474 DOING THE SAME THING WITH THEIR
475 PARENTS.
476 I ALSO THINK ABOUT IT AS A
477 MOTHER, BECAUSE WITH MY OWN
478 SON, YOU KNOW, JUST TRYING TO
479 GET HIS IMMUNIZATION INFORMATION
480 AROUND--AND WE MOVED SEVERAL
481 TIMES.
482 AND TRYING TO GET THAT HISTORY
483 AND KEEP UP WITH IT, IT'S VERY
484 COMPLEX.
485 >> I THINK THAT FOR PROVIDERS,
486 THE GREATEST BENEFIT OF AN
487 INTEROPERABLE HEALTH SYSTEM IS
488 THAT YOU HAVE THE INFORMATION
489 YOU NEED AT YOUR FINGERTIPS TO
490 DO THE RIGHT THING AND JUST THE
491 RIGHT THING AT THE RIGHT TIME
492 AND IN THE RIGHT WAY.
493 TODAY WE DO WHAT WE KNOW TO DO
494 AT BEST ABOUT 60% OF THE TIME.
495 AND IN MANY CASES, ABOUT 40%
496 OF WHAT WE DO IS ACTUALLY
497 UNNECESSARY.
498 >> I FIRST BECAME INVOLVED WITH
499 COMPUTERIZATION OF HEALTHCARE
500 BACK IN THE MID-EIGHTIES.
501 I'M A PHYSICIAN AND HAVE
502 PRACTICED IN THE EMERGENCY ROOM
503 FOR ALMOST 30 YEARS.
504 THAT'S MY SPECIALTY.
505 IN THE EARLY- TO MID-EIGHTIES,
506 I LOOKED AT MY PRACTICE AND
507 REALIZED THAT--AND I THINK THIS
508 IS SOMETHING YOU'LL HEAR FROM
509 MANY PHYSICIANS--THAT MY
510 HANDWRITING WAS SO POOR THAT IT
511 BORDERED ON THE ILLEGIBLE, AND
512 I WAS IN THE MIDST OF A BUSY
513 EMERGENCY ROOM GRABBING NURSES,
514 MAKING SURE THAT THEY
515 UNDERSTOOD MY ORDERS TO MAKE
516 SURE THAT I WAS NOT IN ANY WAY
517 INJURING OR HURTING PATIENTS,
518 MAKING SURE THAT THEY
519 UNDERSTOOD WHAT MY ORDERS FOR
520 TREATMENT, INJECTIONS,
521 MEDICATIONS WERE.
522 I THINK THAT THIS IS REPLICATED
523 THROUGHOUT HEALTHCARE, THIS
524 SORT OF LACK OF COMMUNICATION,
525 THE FACT THAT THE INFORMATION
526 DOESN'T EASILY GET FROM ONE
527 PLACE TO ANOTHER TO REALLY
528 SUPPORT PATIENT CARE AND
529 OPTIMAL HEALTHCARE.
530 >> I THINK THAT PARTICULARLY
531 THE PEOPLE THAT I REALLY FEEL
532 THE MOST SORRY FOR ARE
533 PARTICULARLY MOTHERS, USUALLY
534 MOTHERS, PARENTS OF CHILDREN
535 WITH CHRONIC ILLNESSES OR
536 DEVELOPMENTAL PROBLEMS.
537 THESE POOR PEOPLE HAVE TO GO
538 THROUGH REPEATING THEIR STORY
539 OVER AND OVER AND OVER AGAIN TO
540 A WHOLE ARRAY OF PEOPLE, NOT
541 JUST DOCTORS AND NURSES, BUT
542 INSURERS AND SO FORTH.
543 SO I THINK THEY'RE BOTH
544 OPPORTUNITIES TO AVOID ERRORS
545 AND REAL SERIOUS AFFORDABLE
546 INJURY AND EVEN, IN SOME
547 INSTANCES, DEATH.
548 BUT EQUALLY IMPORTANT, JUST THE
549 AMOUNT OF WEAR AND TEAR THAT
550 WE PUT ON PEOPLE TO GET THEIR
551 CARE IS JUST--IT'S NOT
552 ACCEPTABLE.
553 IT'S NO WAY TO RUN ANYTHING.
554 >> WE ALL HAVE A LOT OF GREAT
555 IDEAS ABOUT WHAT THE FUTURE OF
556 HEALTHCARE WOULD LOOK LIKE IN
557 AN INTEROPERABLE SYSTEM.
558 YOU CAN IMAGINE TRICORDERS,
559 AND YOU CAN IMAGINE PEOPLE
560 GETTING CONNECTIONS FROM ONE
561 PART OF THE GLOBE TO ANOTHER.
562 BUT HONESTLY, I THINK A BIG
563 ADVANTAGE WOULD BE JUST TO
564 SIMPLY GET YOUR PRESCRIPTION
565 TRANSMITTED EASILY TO THE
566 DRUGSTORE ACROSS THE STREET.
567 I THINK IT WOULD--IT'LL MAKE A
568 DIFFERENCE JUST TO REDUCE THE
569 NUMBER OF FORMS YOU HAVE TO
570 FILL OUT IN THE COURSE OF A
571 PATIENT-CARE EPISODE.
572 AND SO I THINK THE ADVANTAGES
573 AND THE OPPORTUNITIES ARE GOING
574 BE IN MANY CASES SMALL,
575 RELATIVELY INSIGNIFICANT
576 TRANSACTIONS THAT, WHEN YOU ADD
577 THEM ALL UP, WILL LITERALLY
578 TRANSFORM THE INDUSTRY AS WE
579 KNOW IT.
580
581 >> INTEROPERABILITY IS A
582 TECHNICAL TERM FOR WORKING
583 TOGETHER.
584 WHEN ALL PARTICIPANTS IN THE
585 HEALTHCARE SYSTEM--PATIENTS,
586 DOCTORS, PHARMACISTS, AND
587 PAYERS, ARE WORKING TOGETHER
588 AS A TEAM ENABLED THROUGH THE
589 COLLABORATIVE USE OF HEALTHCARE
590 INFORMATION TECHNOLOGY, THE
591 BENEFITS WILL BE ENORMOUS.
592 >> THE VALUE OF
593 INTEROPERABILITY, OBVIOUSLY FOR
594 PATIENTS AND CONSUMERS AS WELL
595 AS PROVIDERS, HAS TO DO WITH
596 INCREASING COMMUNICATION AND
597 QUALITY OF CARE.
598 I THINK MANY OF US HAVE HAD
599 EXPERIENCES WHERE PATIENTS HAVE
600 NOT BEEN ABLE TO EASILY
601 COMMUNICATE WITH THEIR
602 PROVIDERS, AND PROVIDERS HAVE
603 NOT BEEN ABLE TO COMMUNICATE
604 EASILY WITH EACH OTHER.
605 THIS HAS REDUCED THE QUALITY
606 OF CARE.
607 >> INTEROPERABILITY BASICALLY
608 SAYS, HOW DO YOU CONNECT ALL THE
609 SERVICES THAT SURROUND THE USE
610 OF ALL THESE GREAT
611 ADVANCEMENTS IN MEDICINE TO
612 MAKE IT USEFUL FOR PEOPLE?
613 >> PERSONALLY, I THINK MOST
614 IMPORTANTLY THE INDIVIDUAL
615 PATIENT HAS AN OPPORTUNITY TO
616 REALLY CARRY INFORMATION TO
617 THEIR DOCTORS OR THEIR NURSES
618 WHEREVER THEY ARE SO THAT, IN
619 FACT, IT'S NOT THIS DIVIDED,
620 SEPARATED BOXES THAT WE
621 CURRENTLY LIVE AND WORK WITH.
622
623 >> THIS ISSUE'S IMPORTANT TO ME
624 BECAUSE I AM FIRST A PROVIDER,
625 AND SO THAT I HAVE TAKEN CARE
626 OF PATIENTS WITHOUT THE
627 INFORMATION I NEED.
628 I ALSO AM A PATIENT, SO I DEAL
629 WITH BOTH THE INCONVENIENCE AND
630 THE QUALITY PROBLEMS ON THE
631 SYSTEMS.
632 AND I KNOW IT'S SOLVABLE NOW,
633 SO I WANT TO SEE US COME
634 TOGETHER TO SOLVE IT.
635 >> THE MOST IMPORTANT ELEMENT
636 OF THE HEALTHCARE INDUSTRY TO
637 DATE HAS BEEN OUR ABILITY TO
638 REMEMBER THINGS.
639 AND I THINK THAT THE MOST
640 IMPORTANT THING WE CAN DO IS TO
641 MAKE SURE THAT PEOPLE'S LIVES
642 DON'T RELY ON THE INDIVIDUAL
643 MEMORIES OF A PARTICULAR PATIENT
644 OR A PARTICULAR PHYSICIAN OR A
645 PARTICULAR TECHNICIAN.
646 AS I GET OLDER, I APPRECIATE
647 MORE THAT HOW FRAGILE MEMORIES
648 CAN BE, AND I JUST CAN'T IMAGINE
649 HAVING MY FUTURE HEALTHCARE
650 NEEDS, THE HEALTHCARE NEEDS OF
651 MY FAMILY, DICTATED ON THE
652 ABILITY OF SOMEBODY TO REMEMBER
653 A PARTICULAR DRUG THAT THEY WERE
654 ON OR A PARTICULAR PROCEDURE
655 THEY HAD YEARS AGO.
656 I THINK THAT'S FRIGHTENING
657 TO ME.
658 AND I THINK IF THERE'S ONE
659 THING WE CAN DO AS A RESULT OF
660 THIS COMMISSION'S WORK, IT'S TO
661 MAKE SURE THAT THE ENTIRE SYSTEM
662 DOESN'T DEPEND ON SOMEBODY'S
663 MEMORY.
664 >> I THINK IT'S IMPORTANT TO
665 EVERYBODY, BECAUSE EVERY ONE OF
666 US--I'M ACTUALLY A PHYSICIAN,
667 BUT I THINK EVERY ONE OF US IS
668 A PATIENT AS WELL, AT LEAST IN
669 TRUTH OR POTENTIALLY.
670 AND INCREASINGLY IN THE U.S.,
671 YOU HAVE THE SITUATION IN WHICH
672 ADULTS ARE CARING FOR CHILDREN,
673 BUT THEY'RE ALSO CARING FOR
674 THEIR PARENTS--A SO-CALLED
675 SANDWICH GENERATION, A VERY
676 COMMON PROPOSITION.
677 AND IN ALL OF THESE
678 CIRCUMSTANCES, HAVING AN
679 UP-TO-DATE HEALTHCARE RECORD IS
680 A REALLY BIG ADVANTAGE.
681 WE ALSO MOVE AROUND A LOT.
682 WE MOVE, AND WE HAVE FAMILY
683 FROM COAST TO COAST.
684 I DO, IN FACT.
685 SO THAT THE ABILITY TO SEE
686 WHAT'S GOING ON WOULD JUST BE A
687 TREMENDOUS ADVANTAGE TO ME
688 PERSONALLY AND, I THINK, AS I
689 SAY, TO JUST ABOUT EVERY
690 AMERICAN.
691
692 >> INTEROPERABILITY WILL HELP
693 TRANSFORM THE HEALTHCARE
694 SYSTEM IN TWO IMPORTANT WAYS.
695 THE FIRST IS FOR PROVIDERS.
696 PEOPLE INVOLVED IN TREATING
697 PATIENTS ARE ANXIOUS TO KNOW AS
698 MUCH INFORMATION AS POSSIBLE IN
699 AS TIMELY A WAY AS POSSIBLE SO
700 THAT THEY CAN MAKE THE BEST
701 DECISION IN THE INTEREST OF THE
702 PATIENTS.
703 AND INTEROPERABLE HEALTHCARE
704 I.T. SYSTEMS WILL GREATLY
705 FACILITATE THAT.
706 THE SECOND WILL BE TO EMPOWER
707 CONSUMERS.
708 THE MORE CONSUMERS AND PATIENTS
709 ARE AWARE OF THEIR OWN
710 HEALTHCARE STATUS, THEIR HEALTH
711 NEEDS, ET CETERA, ET CETERA,
712 THAT REALLY WILL MAKE FOR A
713 BETTER HEALTHCARE SYSTEM FOR ALL
714 OF US, AND I CAN ASSURE YOU THAT
715 PEOPLE ON THE PROVIDER SIDE ARE
716 MOST INTERESTED IN SEEING THAT
717 HAPPEN AS WELL.
718 >> I SEE TRANSFORMING THE
719 HEALTHCARE SYSTEM AS MUCH AS
720 CELL PHONES HAVE TRANSFORMED
721 EVERY ONE OF OUR HOMES ACROSS
722 AMERICA.
723 THERE'S NO TECHNOLOGY OUT THERE
724 THAT WE HAVEN'T INTRODUCED TO
725 OUR OWN LIVES, WHETHER IT BE
726 TELEVISION OR GPS SYSTEMS OR
727 CELL PHONES OR E-MAIL THAT
728 SUDDENLY WHEN YOU INTRODUCE THAT
729 INTO YOUR LIFE, YOU'RE SUDDENLY
730 SO MUCH MORE EMPOWERED.
731 AND SO NOW WITH INTEROPERABLE
732 HEALTHCARE WHERE YOU CAN GET
733 IT WHEN YOU NEED IT, WHAT YOU
734 NEED WHERE YOU NEED IT, IT WILL
735 JUST ABSOLUTELY REVOLUTIONIZE
736 PEOPLE'S HOMES AS MUCH AS, LIKE
737 I SAID, OTHER TECHNOLOGIES
738 ALREADY HAVE.
739 >> IT WILL MEAN THAT THERE CAN
740 BE SEAMLESS CONVERSATION
741 BETWEEN VARIOUS HEALTH
742 PROVIDERS.
743 SO, FOR EXAMPLE, IF SOMEBODY
744 HAS INFORMATION IN ONE SYSTEM,
745 IT CAN EASILY GO TO THE OTHER
746 SYSTEM.
747 PEOPLE WHO WANT THEIR HEALTH
748 RECORDS TRANSMITTED CAN HAVE
749 THEM TRANSMITTED MORE RAPIDLY.
750 ONE DOESN'T HAVE TO WORRY ABOUT
751 TREKKING AROUND WITH X-RAY
752 RECORDS, LAB STATEMENTS, TRYING
753 TO GET THEM FROM PREVIOUS
754 DOCTORS OR PRACTITIONERS THAT
755 YOU'VE BEEN TO, BECAUSE THE
756 INFORMATION SYSTEM WILL MAKE IT
757 JUST ALMOST AUTOMATICALLY
758 AVAILABLE, AGAIN, IF THE
759 PATIENT WANTS IT.
760 >> OR, LIKE, IN ANY USE OF
761 TECHNOLOGY, IT'S GOING TO
762 INCREASE PRODUCTIVITY.
763 IT'S GOING TO INCREASE CAPACITY.
764 WE HAVE SO MANY PEOPLE WHO
765 WEREN'T COVERED NECESSARILY IN
766 THE RIGHT WAY IN OUR COUNTRY BY
767 HEALTHCARE.
768 THIS WILL HELP US REACH MORE
769 PEOPLE IN A MORE SYSTEMIC WAY.
770 I THINK IT WILL ELIMINATE
771 ERRORS, ABSOLUTELY.
772 IT WILL INCREASE, I THINK, THE
773 RELATIONSHIP AND MAKE--HAVE A
774 BETTER RELATIONSHIP BETWEEN THE
775 DOCTORS AND THE PATIENTS, SO
776 THAT WE CAN DELIVER THE RIGHT
777 HEALTHCARE TO EVERYBODY AT THE
778 RIGHT TIME.
779 >> INTEROPERABILITY WILL
780 TRANSFORM THE HEALTHCARE SYSTEM
781 BY GIVING US THE OPPORTUNITY TO
782 BUILD A SYSTEM THAT ISN'T BOUND
783 BY GEOGRAPHY.
784 WE ARE A MOBILE SOCIETY LIVING
785 IN A BIG COUNTRY WHERE A PATIENT
786 MIGHT NEED CARE ON MONDAY IN
787 SAN FRANCISCO AND ON THURSDAY
788 IN NEW YORK.
789 HEALTHCARE INFORMATION
790 TECHNOLOGY WILL REMOVE THE
791 BARRIERS OF GEOGRAPHY, AND GIVE
792 EVERY AMERICAN AND THEIR DOCTORS
793 THE TOOLS THEY NEED TO MAKE THE
794 BEST DECISIONS WHENEVER AND
795 WHEREVER THOSE DECISIONS NEED
796 TO BE MADE.
797
798 >> I HOPE THAT THIS REPORT WILL
799 HELP PEOPLE FOCUS ON HOW TO
800 MOVE THROUGH THIS JOURNEY OVER
801 TIME.
802 THE PROGRESS TOWARD AN
803 INTEROPERABLE HEALTH SYSTEM IS
804 A JOURNEY.
805 IT'S NOT A SINGLE EVENT.
806 AND PEOPLE HAVE BEEN WORKING ON
807 VARIOUS PIECES OF WHAT NEEDS TO
808 BE DONE FOR, YOU KNOW, OVER
809 30 YEARS.
810 WHAT NO ONE'S DONE BEFORE IS TO
811 SIT DOWN AND SAY, "WHAT DO WE
812 HAVE TO DO THIS YEAR AND THEN
813 NEXT YEAR AND THEN THE YEAR
814 AFTER THAT, TO EACH YEAR GET TO
815 A MORE INTEROPERABLE SYSTEM
816 OVER TIME?"
817 WE'VE TRIED TO LAY THAT PATTERN
818 OUT IN THIS REPORT.
819 >> CONGRESS CREATED THIS
820 COMMISSION TO GIVE IT ADVICE,
821 TO GIVE IT INSIGHT.
822 I THINK THAT AT THE SAME TIME,
823 THERE'S A REALIZATION OF THIS
824 IMPENDING TRAIN WRECK OF
825 HEALTHCARE, AND A DESIRE TO TRY
826 AND ADDRESS THAT WITH
827 INFORMATION TECHNOLOGY.
828 THERE'S A HUGE FEAR OF
829 INFORMATION TECHNOLOGY, AND A
830 HUGE LACK OF INFORMATION ABOUT
831 HOW THIS OUGHT TO BE DONE.
832 AND THE IMPACT OF THE
833 COMMISSION'S REPORT REALLY
834 SHOULD BE TO PROVIDE GUIDANCE TO
835 POLICYMAKERS, TO GIVE THEM SOME
836 CONCRETE IDEAS, TO GIVE THEM
837 SOME CONCEPTS AND SOME TIMELINES
838 SO THAT IT'S NOT AN INTRACTABLE
839 PROBLEM; IT'S A SERIES OF STEPS
840 THAT THEY CAN BE TAKING.
841 >> I HOPE THE REPORT REALLY
842 RAISES THE LEVEL OF RECOGNITION
843 OF HOW IMPORTANT THIS IS AND
844 THAT WE CAN'T JUST SIMPLY GO
845 ALONG, GET ALONG.
846 THERE'S A NEED TO REALLY REACT
847 AND TO MAKE THE CHANGES THAT
848 NEED TO HAPPEN.
849 GET THE STANDARDS IN PLACE SO
850 THAT WE CAN REALLY MOVE THIS
851 FORWARD QUICKLY.
852 >> WHETHER IT IS HOSPITALS AND
853 PHYSICIANS, PAYERS, GOVERNMENT,
854 OR SUPPLIERS AND VENDORS, I AM
855 HOPEFUL THAT WE WILL CONTINUE
856 TO BRING THESE GROUPS TOGETHER
857 TO REACH CONSENSUS ON HOW WE
858 ARE GOING TO BETTER INTRODUCE
859 INFORMATION TECHNOLOGY IN
860 HEALTHCARE, MAKE BETTER USE OF
861 IT TO SOLVE OUR PROBLEMS.
862 I THINK THE FIRST STAGE, THE
863 MOST IMPORTANT STAGE, IS THAT WE
864 ALL AGREE ON STANDARDS.
865 WE CAN'T HAVE THE BENEFITS OF
866 INFORMATION TECHNOLOGY UNLESS
867 WE USE COMMON STANDARDS THAT
868 ALLOW US TO SHARE INFORMATION
869 AND DATA EFFECTIVELY.
870 >> I THINK THE IMPACT SHOULD BE
871 TO MAKE THIS REALLY, TRULY A
872 NATIONAL INITIATIVE.
873 WE'VE BEEN WORKING HARD ON THIS
874 FOR 20-SOME YEARS, A NUMBER OF
875 US, AND IT'S REALLY EXCITING TO
876 SEE THE PRESIDENT BEHIND THIS,
877 ELECTRONIC HEALTH RECORDS IN
878 10 YEARS FOR ALL AMERICANS.
879 THE SECRETARY, THE PRIOR
880 SECRETARY.
881 I THINK PEOPLE INCREASINGLY ON
882 THE HILL ON BOTH SIDES OF THE
883 AISLE.
884 I THINK THIS IS CLEARLY A
885 BIPARTISAN KIND OF ACTIVITY.
886 >> I BELIEVE THE IMPACT OF THIS
887 REPORT WILL REALLY BE TWOFOLD.
888 FIRST, I THINK IT WILL BUILD ON
889 SOME MOMENTUM THAT'S ALREADY
890 STARTED, BOTH IN GOVERNMENT
891 CIRCLES, BUT ALSO IN THE PRIVATE
892 SECTOR TO TRY TO MOVE FORWARD
893 IN THIS DIRECTION.
894 THERE ARE SOME CRITICAL PUBLIC
895 POLICY DECISIONS THAT NEED TO BE
896 MADE IN THE NEAR FUTURE IF
897 WE'RE ABLE--IF WE'RE GOING TO
898 BE ABLE TO MOVE FORWARD IN A
899 TIMELY WAY.
900 AND HOPEFULLY THIS WILL PROVIDE
901 THE MOMENTUM TO PUSH THOSE
902 PUBLIC POLICY DECISIONS FORWARD.
903 THE SECOND IS CONSUMERS.
904 AND I HOPE THIS REPORT WILL
905 HELP TO INFORM CONSUMERS ABOUT
906 THE BENEFITS OF INTEROPERABLE
907 HEALTHCARE SYSTEM, HEALTH I.T.,
908 AND TO RAISE THEIR AWARENESS AND
909 THEIR INTEREST IN THIS IMPORTANT
910 TOPIC AS WELL.
911
912 >> I THINK THAT THE GENESIS OF
913 THIS COMMISSION WAS A
914 REALIZATION IN CONGRESS THAT
915 THERE'S A TRAIN WRECK THAT'S
916 GOING TO HAPPEN.
917 WE CAN'T PAY FOR ALL OF THE
918 HEALTHCARE THAT WE'RE USING,
919 ALL OF THE HEALTHCARE THAT'S
920 DEMANDED, THAT IS SOUGHT.
921 AND AT THE SAME TIME, WE'RE
922 STARING AT A SYSTEM THAT IS
923 FRAUGHT WITH INEFFICIENCIES AND
924 PROBLEMS.
925 AND THERE'S A SOLUTION THAT'S
926 OUT THERE.
927 AND THE SOLUTION--ALL OF THE
928 ROADS OF THE SOLUTION LEAD
929 THROUGH INFORMATION TECHNOLOGY.
930 >> I THINK THERE ARE REALLY 3
931 REASONS WHY WE SHOULD FOCUS ON
932 INTEROPERABILITY NOW.
933 THE FIRST IS THAT ONLY IN
934 RECENT YEARS REALLY HAS THE
935 TECHNOLOGICAL CAPABILITY COME
936 ALONG TO BE ABLE TO HANDLE THE
937 ENORMOUS AMOUNTS OF DATA THAT
938 ARE INVOLVED IN HEALTHCARE
939 INFORMATION.
940 SECONDLY, QUALITY IS THE MOST
941 IMPORTANT THING THAT THE
942 AMERICAN HEALTHCARE SYSTEM
943 SHOULD BE PROVIDING TO THE
944 PEOPLE OF OUR COUNTRY.
945 AND INTEROPERABLE HEALTHCARE
946 SYSTEMS WILL FACILITATE THAT A
947 GREAT DEAL.
948 AND THEN FINALLY IS COST.
949 ALL OF US ARE ENORMOUSLY
950 CONCERNED ABOUT THE RISING COST
951 OF HEALTHCARE.
952 AND WHILE THERE ARE CERTAINLY
953 MANY OTHER ELEMENTS THAT ARE
954 CONTRIBUTING TO THAT,
955 INTEROPERABLE HEALTHCARE SYSTEMS
956 WILL BE AN IMPORTANT ELEMENT TO
957 HELP SOLVE THAT ISSUE AS WELL.
958 >> BECAUSE IT'S POSSIBLE NOW.
959 THE TECHNOLOGY HAS REACHED A
960 POINT THAT IT'S NOT A BARRIER TO
961 HAVE INTEROPERABILITY.
962 AND THE--SO THAT'S THE FIRST
963 REASON.
964 THE SECOND REASON IS THAT WE
965 FACE A CRISIS IN HEALTHCARE.
966 THE COST OF OUR CURRENT SYSTEM
967 IS TOO GREAT, AND THE VALUE
968 DELIVERED FOR THAT PRICE IS NOT
969 ADEQUATE.
970 AND FREE MOVEMENT OF INFORMATION
971 IS KEY TO FIXING THAT CRISIS.
972 >> THERE'S NO EXCUSE NOT TO DO
973 IT NOW.
974
975 THE BIGGEST BENEFIT TO
976 CONNECTING PATIENTS AND
977 INDIVIDUALS AND DOCTORS TO
978 HEALTH INFORMATION WILL
979 REVOLUTIONIZE THE LEVEL OF
980 KNOWLEDGE THAT PEOPLE HAVE ABOUT
981 THEIR OWN HEALTH AND WHAT
982 DOCTORS KNOW ABOUT THE PEOPLE
983 THAT THEY'RE TREATING.
984 >> THERE ARE PROBABLY MORE
985 OPPORTUNITIES TO DESCRIBE PLACE
986 AND TIMES WHEN I WANTED
987 INFORMATION AS A DOCTOR, AND
988 COULDN'T GET THE RECORD BECAUSE
989 IT WAS TIED UP, LOCKED UP IN
990 SOMEBODY'S OFFICE OR SOMETHING
991 LIKE THAT.
992 USUALLY YOU FOUND A WAY AROUND
993 IT, BUT THE PROBLEM, OF COURSE,
994 IS THAT WE CAN'T DO THAT
995 ANYMORE.
996 MEDICINE'S BECOMING TOO
997 COMPLICATED.
998 PROTOCOLS FOR SOME ILLNESSES
999 ARE SUCH THAT, IN FACT, IF YOU
1000 DON'T HAVE THE INFORMATION AT
1001 HAND WHEN YOU NEED IT, YOU
1002 REALLY CAN HAVE PROBLEMS.
1003 >> I THINK IN THIS INCREDIBLY
1004 COMPLEX INDUSTRY THAT WE HAVE,
1005 THERE IS JUST SO MANY
1006 OPPORTUNITIES FOR MISTAKES.
1007 THERE ARE SO MANY ERRORS THAT
1008 CAN TAKE PLACE JUST BECAUSE
1009 PEOPLE DON'T HAVE THE RIGHT
1010 INFORMATION AT THE RIGHT TIME.
1011 AND I THINK WE CAN TRULY MAKE A
1012 SIGNIFICANT DIFFERENCE IN THE
1013 LIVES AND HEALTH OF PEOPLE IF
1014 WE CAN JUST GET OUR VARIOUS
1015 COMPUTER SYSTEMS, OUR VARIOUS
1016 DATA SYSTEMS TO CONNECT.
1017 >> I THINK WE SEE THE BENEFITS
1018 OF HAVING HEALTH INFORMATION
1019 THAT'S ONLINE, THAT'S
1020 ACCESSIBLE, THAT YOU CAN TAKE
1021 IT TO THE DOCTOR WHEN YOU NEED
1022 TO GET THERE, SO YOU'RE NOT
1023 FINDING YOURSELF LISTING ALL
1024 YOUR PRESCRIPTIONS AND ALL OF
1025 YOUR SURGERIES OVER AND OVER,
1026 NOT FILLING OUT NUMEROUS FORMS.
1027 IT SIMPLIFIES YOUR LIFE IN MANY
1028 WAYS IN TERMS OF GETTING IT
1029 AROUND.
1030 I EXPERIENCE THAT WITH MY OWN
1031 PARENTS, WHO ARE BOTH DISABLED.
1032 IN TRYING TO BECOME THE FAMILY
1033 HISTORIAN AND GO FROM DOCTOR
1034 TO DOCTOR WITH THEM, HAVING TO
1035 RECOUNT THEIR HISTORY, HAVING
1036 TO REMEMBER ALL OF THEIR DRUGS,
1037 IT REALLY WAS OVERWHELMING IN
1038 MANY, MANY INSTANCES.
1039 AND I LOOK AT SO MANY OF MY
1040 FRIENDS AND NEIGHBORS WHO ARE
1041 DOING THE SAME THING WITH THEIR
1042 PARENTS.
1043 I ALSO THINK ABOUT IT AS A
1044 MOTHER, BECAUSE WITH MY OWN
1045 SON, JUST TRYING TO GET HIS
1046 IMMUNIZATION INFORMATION
1047 AROUND--AND WE MOVED SEVERAL
1048 TIMES.
1049 AND TRYING TO GET THAT HISTORY
1050 AND KEEP UP WITH IT, IT'S VERY
1051 COMPLEX.
1052 >> I THINK THAT FOR PROVIDERS,
1053 THE GREATEST BENEFIT OF AN
1054 INTEROPERABLE HEALTH SYSTEM IS
1055 THAT YOU HAVE THE INFORMATION
1056 YOU NEED AT YOUR FINGERTIPS TO
1057 DO THE RIGHT THING AND JUST THE
1058 RIGHT THING AT THE RIGHT TIME
1059 AND IN THE RIGHT WAY.
1060 TODAY WE DO WHAT WE KNOW TO DO
1061 AT BEST ABOUT 60% OF THE TIME.
1062 AND IN MANY CASES, ABOUT 40% OF
1063 WHAT WE DO IS ACTUALLY
1064 UNNECESSARY.
1065 >> I FIRST BECAME INVOLVED WITH
1066 COMPUTERIZATION OF HEALTHCARE
1067 BACK IN THE MID-EIGHTIES.
1068 I'M A PHYSICIAN AND HAVE
1069 PRACTICED IN THE EMERGENCY ROOM
1070 FOR ALMOST 30 YEARS.
1071 THAT'S MY SPECIALTY.
1072 IN THE EARLY TO MID-EIGHTIES, I
1073 LOOKED AT MY PRACTICE AND
1074 REALIZED THAT--AND I THINK THIS
1075 IS SOMETHING YOU'LL HEAR FROM
1076 MANY PHYSICIANS--THAT MY
1077 HANDWRITING WAS SO POOR THAT IT
1078 BORDERED ON THE ILLEGIBLE, AND
1079 I WAS IN THE MIDST OF A BUSY
1080 EMERGENCY ROOM GRABBING NURSES,
1081 MAKING SURE THAT THEY
1082 UNDERSTOOD MY ORDERS, TO MAKE
1083 SURE THAT I WAS NOT IN ANY WAY
1084 INJURING OR HURTING PATIENTS,
1085 MAKING SURE THAT THEY
1086 UNDERSTOOD WHAT MY ORDERS FOR
1087 TREATMENT, INJECTIONS,
1088 MEDICATIONS WERE.
1089 I THINK THAT THIS IS REPLICATED
1090 THROUGHOUT HEALTHCARE, THIS
1091 SORT OF LACK OF COMMUNICATION,
1092 THE FACT THAT THE INFORMATION
1093 DOESN'T EASILY GET FROM ONE
1094 PLACE TO ANOTHER TO REALLY
1095 SUPPORT PATIENT CARE AND
1096 OPTIMAL HEALTHCARE.
1097 >> I THINK THAT PARTICULARLY
1098 THE PEOPLE THAT I REALLY FEEL
1099 THE MOST SORRY FOR ARE
1100 PARTICULARLY MOTHERS, USUALLY
1101 MOTHERS, PARENTS OF CHILDREN
1102 WITH CHRONIC ILLNESSES OR
1103 DEVELOPMENTAL PROBLEMS.
1104 THESE POOR PEOPLE HAVE TO GO
1105 THROUGH REPEATING THEIR STORY
1106 OVER AND OVER AND OVER AGAIN TO
1107 A WHOLE ARRAY OF PEOPLE, NOT
1108 JUST DOCTORS AND NURSES, BUT
1109 INSURERS AND SO FORTH.
1110 SO I THINK THEY'RE BOTH
1111 OPPORTUNITIES TO AVOID ERRORS
1112 AND REAL SERIOUS AFFORDABLE
1113 INJURY AND EVEN, IN SOME
1114 INSTANCES, DEATH.
1115 BUT EQUALLY IMPORTANT, JUST THE
1116 AMOUNT OF WEAR AND TEAR THAT
1117 WE PUT ON PEOPLE TO GET THEIR
1118 CARE IS JUST--IT'S NOT
1119 ACCEPTABLE.
1120 IT'S NO WAY TO RUN ANYTHING.
1121 >> WE ALL HAVE A LOT OF GREAT
1122 IDEAS ABOUT WHAT THE FUTURE OF
1123 HEALTHCARE WOULD LOOK LIKE IN
1124 AN INTEROPERABLE SYSTEM.
1125 YOU CAN IMAGINE TRICORDERS, AND
1126 YOU CAN IMAGINE PEOPLE GETTING
1127 CONNECTIONS FROM ONE PART OF
1128 THE GLOBE TO ANOTHER.
1129 BUT HONESTLY, I THINK A BIG
1130 ADVANTAGE WOULD BE JUST TO
1131 SIMPLY GET YOUR PRESCRIPTION
1132 TRANSMITTED EASILY TO THE
1133 DRUGSTORE ACROSS THE STREET.
1134 I THINK IT WOULD--IT'LL MAKE A
1135 DIFFERENCE JUST TO REDUCE THE
1136 NUMBER OF FORMS YOU HAVE TO
1137 FILL OUT IN THE COURSE OF A
1138 PATIENT-CARE EPISODE.
1139 AND SO I THINK THE ADVANTAGES
1140 AND THE OPPORTUNITIES ARE GOING
1141 BE IN MANY CASES SMALL,
1142 RELATIVELY INSIGNIFICANT
1143 TRANSACTIONS THAT, WHEN YOU ADD
1144 THEM ALL UP, WILL LITERALLY
1145 TRANSFORM THE INDUSTRY AS WE
1146 KNOW IT.
1147
1148 >> INTEROPERABILITY IS A
1149 TECHNICAL TERM FOR WORKING
1150 TOGETHER.
1151 WHEN ALL PARTICIPANTS IN THE
1152 HEALTHCARE SYSTEM--PATIENTS,
1153 DOCTORS, PHARMACISTS, AND
1154 PAYERS--ARE WORKING TOGETHER AS
1155 A TEAM, ENABLED THROUGH THE
1156 COLLABORATIVE USE OF HEALTHCARE
1157 INFORMATION TECHNOLOGY, THE
1158 BENEFITS WILL BE ENORMOUS.
1159 >> THE VALUE OF
1160 INTEROPERABILITY, OBVIOUSLY FOR
1161 PATIENTS AND CONSUMERS, AS WELL
1162 AS PROVIDERS, HAS TO DO WITH
1163 INCREASING COMMUNICATION AND
1164 QUALITY OF CARE.
1165 I THINK MANY OF US HAVE HAD
1166 EXPERIENCES WHERE PATIENTS HAVE
1167 NOT BEEN ABLE TO EASILY
1168 COMMUNICATE WITH THEIR
1169 PROVIDERS, AND PROVIDERS HAVE
1170 NOT BEEN ABLE TO COMMUNICATE
1171 EASILY WITH EACH OTHER.
1172 THIS HAS REDUCED THE QUALITY
1173 OF CARE.
1174 >> INTEROPERABILITY BASICALLY
1175 SAYS, HOW DO YOU CONNECT ALL THE
1176 SERVICES THAT SURROUND THE USE
1177 OF ALL THESE GREAT
1178 ADVANCEMENTS IN MEDICINE TO
1179 MAKE IT USEFUL FOR PEOPLE?
1180 >> PERSONALLY, I THINK MOST
1181 IMPORTANTLY, THE INDIVIDUAL
1182 PATIENT HAS AN OPPORTUNITY TO
1183 REALLY CARRY INFORMATION TO
1184 THEIR DOCTORS OR THEIR NURSES
1185 WHEREVER THEY ARE, SO THAT, IN
1186 FACT, IT'S NOT AS DIVIDED,
1187 SEPARATED BOXES THAT WE
1188 CURRENTLY LIVE AND WORK WITH.
1189
1190 >> THIS ISSUE'S IMPORTANT TO ME
1191 BECAUSE I AM FIRST A PROVIDER,
1192 AND SO THAT I HAVE TAKEN CARE
1193 OF PATIENTS WITHOUT THE
1194 INFORMATION I NEED.
1195 I ALSO AM A PATIENT, SO I DEAL
1196 WITH BOTH THE INCONVENIENCE AND
1197 THE QUALITY PROBLEMS ON THE
1198 SYSTEMS.
1199 AND I KNOW IT'S SOLVABLE NOW,
1200 SO I WANT TO SEE US COME
1201 TOGETHER TO SOLVE IT.
1202 >> THE MOST IMPORTANT ELEMENT
1203 OF THE HEALTHCARE INDUSTRY TO
1204 DATE HAS BEEN OUR ABILITY TO
1205 REMEMBER THINGS.
1206 AND I THINK THAT THE MOST
1207 IMPORTANT THING WE CAN DO IS TO
1208 MAKE SURE THAT PEOPLE'S LIVES
1209 DON'T RELY ON THE INDIVIDUAL
1210 MEMORIES OF A PARTICULAR PATIENT
1211 OR A PARTICULAR PHYSICIAN OR A
1212 PARTICULAR TECHNICIAN.
1213 AS I GET OLDER, I APPRECIATE
1214 MORE THAT--HOW FRAGILE MEMORIES
1215 CAN BE, AND I JUST CAN'T IMAGINE
1216 HAVING MY FUTURE HEALTHCARE
1217 NEEDS, THE HEALTHCARE NEEDS OF
1218 MY FAMILY, DICTATED ON THE
1219 ABILITY OF SOMEBODY TO REMEMBER
1220 A PARTICULAR DRUG THAT THEY WERE
1221 ON OR A PARTICULAR PROCEDURE
1222 THEY HAD YEARS AGO.
1223 I THINK THAT'S FRIGHTENING
1224 TO ME.
1225 AND I THINK IF THERE'S ONE
1226 THING WE CAN DO AS A RESULT OF
1227 THIS COMMISSION'S WORK, IT'S TO
1228 MAKE SURE THAT THE ENTIRE SYSTEM
1229 DOESN'T DEPEND ON SOMEBODY'S
1230 MEMORY.
1231 >> I THINK IT'S IMPORTANT TO
1232 EVERYBODY, BECAUSE EVERY ONE OF
1233 US--I'M ACTUALLY A PHYSICIAN,
1234 BUT I THINK EVERY ONE OF US IS A
1235 PATIENT AS WELL, AT LEAST IN
1236 TRUTH OR POTENTIALLY.
1237 AND INCREASINGLY IN THE U.S.,
1238 YOU HAVE THE SITUATION IN WHICH
1239 ADULTS ARE CARING FOR CHILDREN,
1240 BUT THEY'RE ALSO CARING FOR
1241 THEIR PARENTS--A SO-CALLED
1242 SANDWICH GENERATION, A VERY
1243 COMMON PROPOSITION.
1244 AND IN ALL OF THESE
1245 CIRCUMSTANCES, HAVING AN
1246 UP-TO-DATE HEALTHCARE RECORD
1247 IS A REALLY BIG ADVANTAGE.
1248 WE ALSO MOVE AROUND A LOT.
1249 WE MOVE, AND WE HAVE FAMILY
1250 FROM COAST TO COAST.
1251 I DO, IN FACT.
1252 SO THAT THE ABILITY TO SEE
1253 WHAT'S GOING ON WOULD JUST BE A
1254 TREMENDOUS ADVANTAGE TO ME
1255 PERSONALLY AND, I THINK, AS I
1256 SAY, TO JUST ABOUT EVERY
1257 AMERICAN.
1258
1259 >> INTEROPERABILITY WILL HELP
1260 TRANSFORM THE HEALTHCARE
1261 SYSTEM IN TWO IMPORTANT WAYS.
1262 THE FIRST IS FOR PROVIDERS.
1263 PEOPLE INVOLVED IN TREATING
1264 PATIENTS ARE ANXIOUS TO KNOW AS
1265 MUCH INFORMATION AS POSSIBLE IN
1266 AS TIMELY A WAY AS POSSIBLE SO
1267 THAT THEY CAN MAKE THE BEST
1268 DECISION IN THE INTEREST OF THE
1269 PATIENT.
1270 AND INTEROPERABLE HEALTHCARE
1271 I.T. SYSTEMS WILL GREATLY
1272 FACILITATE THAT.
1273 THE SECOND WILL BE TO EMPOWER
1274 CONSUMERS.
1275 THE MORE CONSUMERS AND PATIENTS
1276 ARE AWARE OF THEIR OWN
1277 HEALTHCARE STATUS, THEIR HEALTH
1278 NEEDS, ET CETERA, ET CETERA,
1279 THAT REALLY WILL MAKE FOR A
1280 BETTER HEALTHCARE SYSTEM FOR ALL
1281 OF US, AND I CAN ASSURE YOU THAT
1282 PEOPLE ON THE PROVIDER SIDE ARE
1283 MOST INTERESTED IN SEEING THAT
1284 HAPPEN AS WELL.
1285 >> I SEE TRANSFORMING THE
1286 HEALTHCARE SYSTEM AS MUCH AS
1287 CELL PHONES HAVE TRANSFORMED
1288 EVERY ONE OF OUR HOMES ACROSS
1289 AMERICA.
1290 THERE'S NO TECHNOLOGY OUT THERE
1291 THAT WE HAVEN'T INTRODUCED TO
1292 OUR OWN LIVES, WHETHER IT BE
1293 TELEVISION OR GPS SYSTEMS OR
1294 CELL PHONES OR E-MAIL, THAT
1295 SUDDENLY WHEN YOU INTRODUCE THAT
1296 INTO YOUR LIFE, YOU'RE SUDDENLY
1297 SO MUCH MORE EMPOWERED.
1298 AND SO NOW WITH INTEROPERABLE
1299 HEALTHCARE WHERE YOU CAN GET
1300 IT WHEN YOU NEED IT, WHAT YOU
1301 NEED, WHERE YOU NEED IT, IT WILL
1302 JUST ABSOLUTELY REVOLUTIONIZE
1303 PEOPLE'S HOMES AS MUCH AS, LIKE
1304 I SAID, OTHER TECHNOLOGIES
1305 ALREADY HAVE.
1306 >> IT WILL MEAN THAT THERE CAN
1307 BE SEAMLESS CONVERSATION
1308 BETWEEN VARIOUS HEALTH
1309 PROVIDERS.
1310 SO, FOR EXAMPLE, IF SOMEBODY
1311 HAS INFORMATION IN ONE SYSTEM,
1312 IT CAN EASILY GO TO THE OTHER
1313 SYSTEM.
1314 PEOPLE WHO WANT THEIR HEALTH
1315 RECORDS TRANSMITTED CAN HAVE
1316 THEM TRANSMITTED MORE RAPIDLY.
1317 ONE DOESN'T HAVE TO WORRY ABOUT
1318 TREKKING AROUND WITH X-RAY
1319 RECORDS, LAB STATEMENTS, TRYING
1320 TO GET THEM FROM PREVIOUS
1321 DOCTORS OR PRACTITIONERS THAT
1322 YOU'VE BEEN TO, BECAUSE THE
1323 INFORMATION SYSTEM WILL MAKE IT
1324 JUST ALMOST AUTOMATICALLY
1325 AVAILABLE, AGAIN, IF THE
1326 PATIENT WANTS IT.
1327 >> OR, LIKE, IN ANY USE OF
1328 TECHNOLOGY, IT'S GOING TO
1329 INCREASE PRODUCTIVITY.
1330 IT'S GOING TO INCREASE CAPACITY.
1331 WE HAVE SO MANY PEOPLE WHO
1332 AREN'T COVERED NECESSARILY IN
1333 THE RIGHT WAY IN OUR COUNTRY BY
1334 HEALTHCARE.
1335 THIS WILL HELP US REACH MORE
1336 PEOPLE IN A MORE SYSTEMIC WAY.
1337 I THINK IT WILL ELIMINATE
1338 ERRORS, ABSOLUTELY.
1339 IT WILL INCREASE, I THINK, THE
1340 RELATIONSHIP AND MAKE--HAVE A
1341 BETTER RELATIONSHIP BETWEEN THE
1342 DOCTORS AND THE PATIENTS SO THAT
1343 WE CAN DELIVER THE RIGHT
1344 HEALTHCARE TO EVERYBODY AT THE
1345 RIGHT TIME.
1346 >> INTEROPERABILITY WILL
1347 TRANSFORM THE HEALTHCARE SYSTEM
1348 BY GIVING US THE OPPORTUNITY TO
1349 BUILD A SYSTEM THAT ISN'T BOUND
1350 BY GEOGRAPHY.
1351 WE ARE A MOBILE SOCIETY LIVING
1352 IN A BIG COUNTRY WHERE A PATIENT
1353 MIGHT NEED CARE ON MONDAY IN
1354 SAN FRANCISCO AND ON THURSDAY
1355 IN NEW YORK.
1356 HEALTHCARE INFORMATION
1357 TECHNOLOGY WILL REMOVE THE
1358 BARRIERS OF GEOGRAPHY, AND GIVE
1359 EVERY AMERICAN AND THEIR DOCTORS
1360 THE TOOLS THEY NEED TO MAKE THE
1361 BEST DECISIONS WHENEVER AND
1362 WHEREVER THOSE DECISIONS NEED
1363 TO BE MADE.
1364
1365 >> I HOPE THAT THIS REPORT WILL
1366 HELP PEOPLE FOCUS ON HOW TO
1367 MOVE THROUGH THIS JOURNEY OVER
1368 TIME.
1369 THE PROGRESS TOWARD AN
1370 INTEROPERABLE HEALTH SYSTEM IS
1371 A JOURNEY.
1372 IT'S NOT A SINGLE EVENT.
1373 AND PEOPLE HAVE BEEN WORKING ON
1374 VARIOUS PIECES OF WHAT NEEDS
1375 TO BE DONE FOR, YOU KNOW, OVER
1376 30 YEARS.
1377 WHAT NO ONE'S DONE BEFORE IS TO
1378 SIT DOWN AND SAY, "WHAT DO WE
1379 HAVE TO DO THIS YEAR AND THEN
1380 NEXT YEAR AND THEN THE YEAR
1381 AFTER TO THAT TO EACH YEAR GET
1382 TO A MORE INTEROPERABLE SYSTEM
1383 OVER TIME?"
1384 WE'VE TRIED TO LAY THAT PATTERN
1385 OUT IN THIS REPORT.
1386 >> CONGRESS CREATED THIS
1387 COMMISSION TO GIVE IT ADVICE, TO
1388 GIVE IT INSIGHT.
1389 I THINK THAT AT THE SAME TIME
1390 THERE'S A REALIZATION OF THIS
1391 IMPENDING TRAIN WRECK OF
1392 HEALTHCARE, AND A DESIRE TO TRY
1393 AND ADDRESS THAT WITH
1394 INFORMATION TECHNOLOGY.
1395 THERE'S A HUGE FEAR ABOUT
1396 INFORMATION TECHNOLOGY AND A
1397 HUGE LACK OF INFORMATION ABOUT
1398 HOW THIS OUGHT TO BE DONE.
1399 AND THE IMPACT OF THE
1400 COMMISSION'S REPORT REALLY
1401 SHOULD BE TO PROVIDE GUIDANCE TO
1402 POLICYMAKERS TO GIVE THEM SOME
1403 CONCRETE IDEAS, TO GIVE THEM
1404 SOME CONCEPTS AND SOME TIME
1405 LINES, SO THAT IT'S NOT AN
1406 INTRACTABLE PROBLEM; IT'S A
1407 SERIES OF STEPS THAT THEY CAN
1408 BE TAKING.
1409 >> I HOPE THE REPORT REALLY
1410 RAISES THE LEVEL OF RECOGNITION
1411 OF HOW IMPORTANT THIS IS, AND
1412 THAT WE CAN'T JUST SIMPLY GO
1413 ALONG, GET ALONG.
1414 THERE'S A NEED TO REALLY REACT
1415 AND TO MAKE THE CHANGES THAT
1416 NEED TO HAPPEN.
1417 GET THE STANDARDS IN PLACE SO
1418 THAT WE CAN REALLY MOVE THIS
1419 FORWARD QUICKLY.
1420 >> WHETHER IT IS HOSPITALS AND
1421 PHYSICIANS, PAYERS, GOVERNMENT,
1422 OR SUPPLIERS AND VENDORS, I AM
1423 HOPEFUL THAT WE WILL CONTINUE
1424 TO BRING THESE GROUPS TOGETHER
1425 TO REACH CONSENSUS ON HOW WE
1426 ARE GOING TO BETTER INTRODUCE
1427 INFORMATION TECHNOLOGY IN
1428 HEALTHCARE, MAKE BETTER USE OF
1429 IT TO SOLVE OUR PROBLEMS.
1430 I THINK THE FIRST STAGE, THE
1431 MOST IMPORTANT STAGE, IS THAT WE
1432 ALL AGREE ON STANDARDS.
1433 WE CAN'T HAVE THE BENEFITS OF
1434 INFORMATION TECHNOLOGY UNLESS
1435 WE USE COMMON STANDARDS THAT
1436 ALLOW US TO SHARE INFORMATION
1437 AND DATA EFFECTIVELY.
1438 >> I THINK THE IMPACT SHOULD BE
1439 TO MAKE THIS REALLY, TRULY A
1440 NATIONAL INITIATIVE.
1441 WE'VE BEEN WORKING HARD ON THIS
1442 FOR 20-SOME YEARS, A NUMBER OF
1443 US, AND IT'S REALLY EXCITING TO
1444 SEE THE PRESIDENT BEHIND THIS,
1445 ELECTRONIC HEALTH RECORDS IN
1446 10 YEARS FOR ALL AMERICANS.
1447 THE SECRETARY, THE PRIOR
1448 SECRETARY.
1449 I THINK PEOPLE INCREASINGLY ON
1450 THE HILL ON BOTH SIDES OF THE
1451 AISLE.
1452 I THINK THIS IS CLEARLY A
1453 BIPARTISAN KIND OF ACTIVITY.
1454 >> I BELIEVE THE IMPACT OF THIS
1455 REPORT WILL REALLY BE TWOFOLD.
1456 FIRST, I THINK IT WILL BUILD ON
1457 SOME MOMENTUM THAT'S ALREADY
1458 STARTED BOTH IN GOVERNMENT
1459 CIRCLES BUT ALSO IN THE PRIVATE
1460 SECTOR TO TRY TO MOVE FORWARD
1461 IN THIS DIRECTION.
1462 THERE ARE SOME CRITICAL PUBLIC
1463 POLICY DECISIONS THAT NEED TO BE
1464 MADE IN THE NEAR FUTURE IF
1465 WE'RE ABLE--IF WE'RE GOING TO
1466 BE ABLE TO MOVE FORWARD IN A
1467 TIMELY WAY.
1468 AND HOPEFULLY THIS WILL PROVIDE
1469 THE MOMENTUM TO PUSH THOSE
1470 PUBLIC POLICY DECISIONS FORWARD.
1471 THE SECOND IS CONSUMERS.
1472 AND I HOPE THIS REPORT WILL
1473 HELP TO INFORM CONSUMERS ABOUT
1474 THE BENEFITS OF INTEROPERABLE
1475 HEALTHCARE SYSTEM, HEALTH I.T.,
1476 AND TO RAISE THEIR AWARENESS AND
1477 THEIR INTEREST IN THIS IMPORTANT
1478 TOPIC AS WELL.
1479
1480 >> I THINK THAT THE GENESIS OF
1481 THIS COMMISSION WAS A
1482 REALIZATION IN CONGRESS THAT
1483 THERE'S A TRAIN WRECK THAT'S
1484 GOING TO HAPPEN.
1485 WE CAN'T PAY FOR ALL OF THE
1486 HEALTHCARE THAT WE'RE USING,
1487 ALL OF THE HEALTHCARE THAT'S
1488 DEMANDED, THAT IS SOUGHT.
1489 AND AT THE SAME TIME, WE'RE
1490 STARING AT A SYSTEM THAT IS
1491 FRAUGHT WITH INEFFICIENCIES AND
1492 PROBLEMS.
1493 AND THERE'S A SOLUTION THAT'S
1494 OUT THERE.
1495 AND THE SOLUTION--ALL OF THE
1496 ROADS OF THE SOLUTION LEAD
1497 THROUGH INFORMATION TECHNOLOGY.
1498 >> I THINK THERE ARE REALLY 3
1499 REASONS WHY WE SHOULD FOCUS ON
1500 INTEROPERABILITY NOW.
1501 THE FIRST IS THAT ONLY IN
1502 RECENT YEARS REALLY HAS THE
1503 TECHNOLOGICAL CAPABILITY COME
1504 ALONG TO BE ABLE TO HANDLE THE
1505 ENORMOUS AMOUNTS OF DATA THAT
1506 ARE INVOLVED IN HEALTHCARE
1507 INFORMATION.
1508 SECONDLY, QUALITY IS THE MOST
1509 IMPORTANT THING THAT THE
1510 AMERICAN HEALTHCARE SYSTEM
1511 SHOULD BE PROVIDING TO THE
1512 PEOPLE OF OUR COUNTRY.
1513 AND INTEROPERABLE HEALTHCARE
1514 SYSTEMS WILL FACILITATE THAT A
1515 GREAT DEAL.
1516 AND THEN FINALLY IS COST.
1517 ALL OF US ARE ENORMOUSLY
1518 CONCERNED ABOUT THE RISING COST
1519 OF HEALTHCARE.
1520 AND WHILE THERE ARE CERTAINLY
1521 MANY OTHER ELEMENTS THAT ARE
1522 CONTRIBUTING TO THAT,
1523 INTEROPERABLE HEALTHCARE SYSTEMS
1524 WILL BE AN IMPORTANT ELEMENT TO
1525 HELP SOLVE THAT ISSUE AS WELL.
1526 >> BECAUSE IT'S POSSIBLE NOW.
1527 THE TECHNOLOGY HAS REACHED A
1528 POINT THAT IT'S NOT A BARRIER TO
1529 HAVE INTEROPERABILITY.
1530 AND THE--SO THAT'S THE FIRST
1531 REASON.
1532 THE SECOND REASON IS THAT WE
1533 FACE A CRISIS IN HEALTHCARE.
1534 THE COST OF OUR CURRENT SYSTEM
1535 IS TOO GREAT, AND THE VALUE
1536 DELIVERED FOR THAT PRICE IS NOT
1537 ADEQUATE.
1538 AND FREE MOVEMENT OF
1539 INFORMATION IS KEY TO FIXING
1540 THAT CRISIS.
1541 >> THERE'S NO EXCUSE NOT TO DO
1542 IT NOW.
1543
