May 30, 2008

Panel explores ways to heal nation’s health care system

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U.S. Sen. Bob Corker, right, was at Vanderbilt this week for a roundtable discussion on the country’s health care system with, among others, Martin Sandler, M.B., Ch.B., left and Chancellor Nicholas Zeppos. (photo by Neil Brake)

Panel explores ways to heal nation’s health care system

Health care providers must take the lead in reforming the health care system, U.S. Sen. Bob Corker said during a roundtable discussion Monday at the Monroe Carell Jr. Children's Hospital at Vanderbilt.

Congress will solve the problem of health care financing, predicted the Tennessee Republican, who is co-sponsoring legislation to ensure that “every family in America” has access to health insurance.

But making the system work in a way that will avoid waste, control cost and emphasize outcomes “is a very difficult thing to do top-down,” he cautioned.

In particular, the “silos” that make up the health care system must utilize existing technology so they can communicate with each other. “It's hard for me to believe we haven't made this happen,” Corker said.

It's already happening, but to a limited extent, responded Mark Frisse, M.D., M.B.A., Accenture Professor of Biomedical Informatics at Vanderbilt University Medical Center, and director of the Regional Informatics Programs at the Vanderbilt Center for Better Health.

In 2004, Vanderbilt helped launch a government-funded health information exchange governed by the Memphis-based MidSouth eHealth Alliance. This exchange makes available, in a secure way, clinical information for nearly one million people who have sought care from any of the major health care providers in Memphis.

Information is shared only with patient consent and is available when they seek care in all major emergency departments, as well as in a number of other hospital and ambulatory care settings, Frisse said.

“There is a willingness (among insurers) to pay for value,” added Jim Jirjis, M.D., M.B.A., chief medical information officer for outpatient clinics at Vanderbilt. However, “there is a vacuum of standards and agreed-upon incentives … (and) we don't have the infrastructure to handle or deal with accurately measuring value in the current systems.”

In addition, the health care system currently ignores behavioral, social and environmental factors that contribute to most of the preventable mortality in this country, said William Stead, M.D., associate vice chancellor for Strategy/Transformation and director of the Informatics Center at Vanderbilt.

“There are huge resource allocation choices here,” he said.

“To me, it's not primarily a technical problem,” Frisse concluded. “It's a problem with the way we think.”

Other Vanderbilt participants in the discussion were Children's Hospital CEO Kevin Churchwell, M.D., Nursing School Dean Colleen Conway-Welch, Ph.D.; Martin Sandler, M.B., Ch.B., associate vice chancellor for Hospital Affairs; and Vanderbilt Chancellor Nicholas Zeppos, J.D.