Healthcare information technology can collect and help analyze the quality measures the United States must have to integrate care, says the chief of the largest healthcare payer in the country, who added that the status quo of fragmented patient health information and fragmented care is no longer acceptable. "We owe Americans journeys of care, not fragments of care,” Donald Berwick, MD, the administrator of the Centers for Medicare & Medicaid Services (CMS) told an audience Sept. 13 at America's Health Insurance Plans (AHIP) Medicare Conference in the nation’s capital.
All of the physicians involved in a patient's episode of care need access to a single set of electronic health records, Berwick said. With the passage of the HITECH Act in 2009, the Obama Administration set a course toward nationwide adoption of electronic health records, which can help eliminate medical errors. Reducing medical errors is at the top of Berwick’s to-do list, he said. It was part of his quest, too, in his former work as head of the Institute for Healthcare Improvement in Cambridge, Mass. Berwick said he will guide CMS in targeting what he called the "triple aims," better care, better population health and reduction of per capita healthcare costs. To do so, CMS will put an emphasis on chronic disease prevention. America is "seriously underinvested" in preventing the epidemic of chronic disease it now faces, he said.
Nora Super, director of federal government relations, health and long-term care at AARP said only one quarter of Medicare beneficiaries are enrolled in highest rated health plans. Super said AARP supported the passage of health reform and the organization believes there should be national standards for quality. "Americans should not settle for poor healthcare quality simply because they live in a certain zip code," she said.
At a Health IT Policy Committee meeting in August 2010, David Blumenthal, MD, the National Coordinator for Health Information Technology endorsed quality of care data collection as established under the HITECH Act. Blumenthal said collecting data on care brings out the best in physicians.
President Obama's recess appointment of Berwick bypassed Congressional hearings and sparked controversy. Days after Berwick was sworn in on July 12, Republican members of the House Ways and Means Committee called for a confirmation hearing. They said seniors have a right to hear how the man in charge of the agency’s $800 billion annual budget plans to handle it. At press time, no hearing had been set.
However, healthcare IT leaders supported the choice.
"Dr. Berwick's passion, intellect, and perseverance make him a perfect person to head up CMS," said Paul Tang, MD, an internist and vice president, chief medical information officer at the Palo Alto Medical Foundation in Palo Alto, Calif. Tang also serves as vice chair of the federal Health IT Policy Committee.
"Dr. Berwick's oft-stated affection for England's socialized medicine system and its rationing body, the National Institute for Clinical Excellence (NICE), is controversial and of great concern to the American people," said Twila Brase, president of the nonprofit advocacy group Citizens' Council on Health Care.
Lois Heim, MD, who heads the American Academy of Family Physicians, saw those accusations as nonsense.
"His history is not one of rationing," Heim said. "His history is about bringing about quality."
