June 25, 2008 By Andy Opsahl
In San Francisco, Accenture recently hosted the last of its three town hall meetings gauging citizen views on health-care challenges and solutions in partnership with the Council for Excellence in Government. The other two meetings occurred in Miami and Detroit. As health-care costs and the number of uninsured citizens climb, some form of government-supported universal health coverage is becoming more likely in the United States, according to panelists at the San Francisco meeting.
Universal health coverage could make a national electronic medical record (EMR) infrastructure critical to managing such a massive, complex health-care system. A national move to EMRs would create new business opportunities for the IT industry. These gatherings allowed Accenture to test the waters of citizen receptivity to a national EMR system. Meeting attendees have been surprisingly open to the EMR idea, said Ken Dineen, global managing director of Accenture's health industry practice. The company's polling data showed 79 percent support for EMR among Miami citizens, 59 percent in Detroit and 74 percent in San Francisco. Privacy and security concerns about such a system fuel the usual objections.
EMR advocates insist the common practice of transferring handwritten medical records between medical establishments is arcane. Dr. Paul Volberding, chief of medical service for the San Francisco Veterans Affairs Medical Center, expressed that view on the event's panel.
"Can you imagine going to your bank and having them write out your account, keeping track of it by pen and paper, and then you go to another bank and they don't have that record? We wouldn't tolerate it, so why do we tolerate it in a health-care system that doesn't have the most basic thing, which is a national electronic medical records system?" Volberding said.
EMR advocates also argue that an electronic system would let doctors run treatment reports for patients similar to theirs, which would aid in better patient care. Those reports, EMR advocates say, would help doctors catch early symptoms before advancing to expensive treatment.
"It would give the whole system the ability to watch what's happening and how decisions are being made. Are providers providing high-quality care? Are they spending more resources than necessary given the patient's health-care needs? I don't think there is any question that it would bring down the cost of health care," Volberding said.
If any EMR opponents attended the meeting, they didn't voice their opinion on the topic.
Daniel Zingale, senior adviser to California Gov. Arnold Schwarzenegger, sat on the panel and advocated an electronic prescription system for the state. "We could reduce medical errors by about a third if we just went to electronic medical prescriptions instead of handwriting," Zingale said.
This Digital Communities white paper highlights discussions with IT officials in four counties that have adopted shared services models. Our aim was to learn about the obstacles these governments have faced when it comes to shared services and what it takes to overcome those roadblocks. We also spoke with several members of the IT industry who have thought long and hard about these issues. The paper offers some best practices for shared government-to-government services, but also points out challenges that government and industry still must overcome before this model gains widespread adoption.