Interview with Joel White, Executive Director, Health IT Now! Coalition

Joel White, Executive Director, Health IT Now! Coalition

Mr. White runs Washington, D.C. based consulting firm, JC White Consulting, and provides clients with strategic, political and policy advice to help navigate the Congressional and Regulatory processes. His focus is primarily on health and tax issues. In addition, he is a Visiting Senior Fellow at the Galen Institute, a non-profit research organization devoted to health and tax policy. Mr. White is on ASHIM’s Health IT Industry Advisory Panel (HIT-IAP).

Interview

ASHIM: The availability of funds through the ARRA (American Recovery and Reinvestment Act of 2009) is on a one year timeline for hospitals and 18 months for individually practicing physicians. Do you believe these funds (total $63,750 over 5 years) will entice enough practitioners to take advantage of the program?

Joel White: That is a fundamental business profit and loss issue. Most physicians have a $400,000 to $500,000 revenue stream… so a ten percent incentive may not be enough. Also, the expenditure for new hardware and software is around $45,000 to $70,000. The question a doctor will ask…is my change in procedure and operation going to decrease productivity and show up in my bottom line in the short term. The answer has to be yes.

This funding of HIT will succeed if it leverages behavior! By that I mean, the funding is a tool to deliver more active and better service to patients. Through computerization of healthcare will become more proactive instead of its current reactive process.

Additionally, the financial aspect is really secondary to the benefits of HIT in the long run. Physicians have always decried the fact they spend less time with patients then with administrative tasks. IT has changed every industry (finance, auto, manufacturing, etc) to a more productive and efficient operation and now it’s time for healthcare to do the same.

The increase in efficiency in this case will be an overall improved healthcare system for a patient’s medical and lifestyle needs.

ASHIM: How do you see HIT being more proactive?

JW: Certainly more data will be available instantly providing the doctor resources to make quicker decisions. As an example, rapid weight gain for a congestive heart failure patient can be a significant warning sign. Today the patient is instructed to call the doctors office to report any changes.

However, with HIT the weight scale the patient uses could send a signal instantly to their Electronic Health Records (EHR). The office is alerted and provides the physician with the data. In this way the doctor’s office can be proactive in monitoring the patient and setting up an office visit. Time is lost when a patient is requested to take action, sometimes causing significant consequences.

AHSIM: What do you see on the horizon from Washington that will help HIT reach its goal of 40% participation by 2012?

JW: Many things are still unclear as to how all this ARRA funding will get into the hands of the practitioners. One issue circulating in the halls of congress, since the funding currently only includes practices that accept Medicare and Medicaid, is how the remainder of the healthcare industry (60%) can be enticed to make the changes.

The benefits of HIT are really not difficult to sell. Younger physicians who have grown up with current technology will readily adapt and set up their practices with technology in mind. It is the seasoned physicians who basically have to reeducate themselves. The time factor is a major deterrent, because they see it as just another thing they have to do away from their primary goal of serving patients.

We’re hoping as these changes are implemented and software becomes more user friendly, those who are resistant to change will see the incredible advantages and embrace it. Remember, the goal in the end is to increase the time with a patient, decrease the administrative workload, reduce patient errors, and hopefully improve the bottom line. Over the last ten years, practitioners have seen a significant erosion of their net income. With HIT, I see everyone benefiting!

ASHIM: Any suggestions for physicians or IT professionals that may make this entire process easier?

JW: Without a doubt, this is a great time for IT people in healthcare; a field which has a really bright future. It is projected the major stumbling block to meet the time lines will be the lack of IT savvy individuals in medicine. Those industries in a recession may provide the resources to solve that issue.

For physicians? I would say get into the “know” as quickly as you can. If the changes are approached over the next two years in a constructive and positive manner, I see the transition to be much easier and cost effective then waiting until the end and doing it all at once.

Also, physicians should use their associations to work toward what they want and need, not have it come from the top down. I think working from the bottom up with Washington will certify results benefiting patients and physicians. Everyone needs to remember, third party payers are well organized and intend to protect their interests, other participants in healthcare should do the same.

Physicians are intelligent business people who will easily see all the benefits of EHR and HIT and will join once there is clarity in how all this will work. The true challenge is for regulators to provide all the tools needed to convert an outdated system into a model of efficiency.

Joel White  interviewed by Tom Criser, Published Sept 17, 2009 © ASHIM