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How to Heal Health Care

By Bill Frist and Hillary Clinton
Wednesday, August 25, 2004; Page A17

At a time when much of our public discussion is riddled with disagreement, there is an emerging bipartisan consensus in one vitally important area: that the challenges facing U.S. health care require major, transformative change. Some steps are already underway. Recently the Department of Health and Human Services announced a 10-year plan to build a new health information infrastructure. And while there is no consensus yet on all the changes needed, we both agree that in a new system, innovations stimulated by information technology will improve care, lower costs, improve quality and empower consumers.

Today our care is often afflicted by systemic error and dramatic inefficiencies. According to a recent Rand Corp. study, even patients with the best available coverage receive recommended care, on average, only 55 percent of the time. Costs continue to escalate far in excess of inflation. Health care providers are paid for episodes of care when a patient is sick or injured, rather than for ensuring that patients are healthy. In other words, patients pay to be covered by a plan or seen by a doctor, not necessarily to receive effective, high-quality treatment. Care is too often oriented toward acute, episodic illnesses of the past -- not the chronic diseases that plague us now. Competition occurs among plans, networks and payers. It often does not sort out the best preventive, diagnostic and treatment strategies.


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Moreover, our current health care sector suffers from profound technological inconsistencies. We lead the world in medical breakthroughs using some of the most advanced technologies ever developed. But at the same time, doctors and nurses struggle under mounds of paperwork, providers lose time trying to manage data and the latest research takes years to reach medical practices. By using advances in information technology, we can put the right information in the hands of doctors and patients at the right time. We can empower patients, health care providers and health care purchasers to make better choices.

Businesses in other sectors have embraced the information revolution to cut costs and improve productivity. They use information technologies not as an end but as a means to improve and innovate. It's time we realize the full potential of the information revolution to improve the quality of the health care system as well.

The success of U.S. health care depends on patients' taking charge of their care and becoming active participants in it. Information and access to it will be paramount. Consumers and patients do not have enough information to make good choices. They need this information, including access to their own health records, and the tools to make better choices, manage their care more effectively and communicate more efficiently with their health care providers. At the same time, we must ensure the privacy of the systems, or they will undermine the trust they are designed to create.

We must also cultivate competition: Consumers need to know which doctors or care settings heal patients faster and better. Consumers need relevant information about providers' experiences and outcomes.

We need to create standards of quality measurement so consumers can shop for good health care. More than a decade ago, the state of New York launched a revolutionary program of public reporting on heart bypass surgery. Last year the New York Chamber of Commerce built on this effort by sponsoring the first statewide hospital report card.

Finally, consumers need information about the price of care. They must be able to compare health care pricing -- with information that is readily, publicly available.

Certainly, government has a job to do with leadership and federal investment in health information technology and quality standards. For instance, we need interoperability standards so systems can communicate with each other, privacy protections, targeted investment and payment systems that reward quality care. The executive branch has taken a number of steps; all agree we need to do more.

The marketplace also has an important role. Consumers must demand quality health care and the tools to provide it, such as pricing and performance information powered by robust information technologies. If these things are done, we believe the quality of care we receive in this country can be radically improved.

Bill Frist is a Republican senator from Tennessee and Senate majority leader. Hillary Clinton is a Democratic senator from New York.


© 2004 The Washington Post Company