"Re-engineering care is necessary and compelling no matter what comes out of the food fight in Washington," said Glenn Steele to a packed audience at Everything Channel's Healthcare IT Summit Monday in La Quinta, Calif. "I am absolutely convinced that you are part of that because of the need for real-time data and the ability to transmit that data."
Steele would know. As President and CEO of Danville, Pa.-based Geisinger Health System, Steele and his organization are working to change the mechanics of the insurer-caregiver-patient delivery system, using a fully integrated electronic health record (EHR), and drawing on Geisinger's unique position as a health care organization with feet in both the provider and payer arenas.
"We're not only an integrated delivery system, with provider facilities and physical care. We're also an insurance company," Steele explained during a keynote address at Healthcare IT Summit.
Having both provider and payer businesses as part of Geisinger has allowed Steele and his executives to better understand the cracks in both how care is provided to patients and how that care is paid for and insured -- two undoubtedly timely topics given the intense health care legislation debates going on in Congress right now.
Geisinger's EHR accounts for 4.4 percent of its annual revenue, Steele said. The company also has networked personal health records (PHRs), what Steele called "outreach EHR" (network operability with more than 2,300 non-Geisinger physician users) and a regional health information exchange encompassing 11 central Pennsylvania hospitals, and more than 90 physician practices and 2.5 million patients.
Geisinger contended that by re-engineering how health-care systems work on a national scale, health-care organizations would see an "unusual framing of the conversation around what's best for the patient." He cited statistics such as that 25 percent of Medicare patients discharged from hospitals in the U.S. are readmitted to that hospital within 30 days -- something that's not only "unacceptable" but also "a fairly concrete and worthy goal" to attack, he explained.
"There's an opportunity for a much more national discussion, particularly as cost overruns and demand curves are both much greater than anything built into the present reform legislation," Steele suggested.
Geisinger's work targets what Steele described as "the four original sins of suboptimal health care in the United States:" unjustified variation, fragmentation of caregiving, perverse payment incentives and the patient as a passive recipient of care.
It's change to that last one -- passive patients -- where the health care system could see the biggest upside over the next decade, Steele suggested.
"Access to data "- allowing data to be as close to the patient as possible -- is crucial," he said. "But data without a long-term human relationship with it has been shown over and over again to not lead to appropriate transactions. There has to be some combination of the two."