"We're at an inflection point," said Paul Tang, MD, vice president and chief medical information officer at Palo Alto Medical Foundation, in his keynote speech at AHIMA on Tuesday. "For once, the stars are aligned."
Tang's speech was focused on "redesigning a health system. The need for change is urgent, an assertion he supported with some sobering, sometimes alarming, charts and statistics.
Many of the facts are well-worn by now. The United States spends $2.5 trillion per year on healthcare: far too much for too little. "By definition," said Tang, "it's just wrong."
And with Baby Boomers set to enter old age in record numbers, the problem is heading for a serious crisis. So far, there's been little headway made in bending that cost curve.
And where "the private markets have failed" thus far, he said, "public policy is required."
Enter the ARRA, and the government's strong, swift push for health IT adoption.
So far, "one of the biggest push-backs," said Tang, "is that this is [happening] really hard, and really fast."
Instead, he made clear, it's barely happening fast enough.
The "incentive program was front-loaded, trying to get as many people to move as quickly as possible." Of course, once that flush of cash has hopefully impelled a critical mass of care providers to get on board, "by 2015, the incentives are removed and the sticks start coming in."
Tang, who sits on the federal Health IT Policy Committee, is encouraged by what he sees so far.
Thanks to this "$27 billion tail wagging a $2.5 trillion dog," he said, "there's more movement amid providers and vendors than ever before… all of a sudden we have the docs' attention."
But mere adoption is not enough, Tang said. It's imperative, to raise the bar on EHR functionality. To bolster privacy protection. And to bring the patient into the fold.
Indeed, that last part is especially crucial. True transformation "starts with understanding: what is the patient's perspective? How does it feel?" said Tang: the aim should be to create not just a personal health record but a "personalized health record."
"This is a different kind of transformation," said Tang. "A transformation of our relationship with patients." That movement toward change, driven by public policy, "is essential for reform."
