After IT, there’s more that needs fixing

Barry Chaiken, MD, has long been a staunch champion for health IT, but technology is not enough, he says. Chaiken, chief medical officer of DocsNetwork Ltd., and outgoing HIMSS chairman, issued a call to action Tuesday at iHT2 Summer Health IT Summit in Denver.

“We need clinical transformation, and we need it now,” he told his audience.

That transformation, of course, includes IT. But, he said, “we need to be smart at implementing technology.”

Chaiken also laid out other areas that need immediate attention in order to improve healthcare quality and patient safety.

Comparative effectiveness research. It’s a ‘dirty word’ in some quarters, he acknowledged. But, there’s nothing to fear. It’s just medical research. “It’s trying to find out what works better,” he said. “It’s not death panels; it’s science.” An example, he said, is using a diuretic to control high blood pressure. It’s been shown to be effective and inexpensive. “If it works, let’s use it,” he said.
Privacy and security. Sharing of data is vital to the interoperable healthcare system the nation envisions. But many patients are worried about giving up their health information. “They’re afraid,” Chaiken said. “Why? Because they think it will be used against them. We need to make sure that doesn’t happen.”
Medical malpractice. “That system is broken,” said Chaiken, and, too often, people who are injured never see a penny. Moreover, “a lot of people who commit malpractice have a blind spot in a certain area,” he added. “We could retrain them. Instead, we hide, cover it up, and eventually we sue them. We need a malpractice system that’s no fault. Today’s malpractice system does nothing to empower quality.”
Protocols. The use of protocols is so vital to quality care, Chaiken said. Oncology, for example, is driven by protocols, yet some physicians are using ones that are years old. Protocols should be exactly the same, he said. “This is not magic stuff. We know it. We need to make the knowledge transfer happen.”
Best practices. Best practices should be vested in science. “We should not be vested in what we did before,” whether it was at Harvard or Yale or any other place, said Chaiken.
Vendors: Technology vendors are motivated to implement their products as quickly as possible. “It’s not because they’re evil,” he said. “It’s because they can’t recognize revenue until the implementation is done. That’s an obstacle to clinical transformation.”
Medical training. Substitute memorizing lists with learning about best pracitices, Chaiken suggested. Make use of case studies. “We have to transform medical education,” he said.

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