When I go through my notes at the end of every conference, I discover a number of interesting thoughts from presenters and attendees that for one reason or another never made it into any of my blog posts. Herewith is a sampling from the last four days at IHI:
- “Health care has no intrinsic value,” said IHI President Don Berwick. “Health does. Joy does. Peace does.” He added, “The best health care is the least health care that we need.”
- David Classen, M.D., who led a session on ARRA funding for clinical IT, said that there had been a tug-of-war within the Obama health care team over how to define meaningful use of the EHR. One side wanted it to focus on vendors and software and the other side wanted it to be based on outcomes. “The National Quality Forum won,” said Classen, associate professor of medicine, senior partner and CMO, Computer Sciences Corp. “The quality and safety model was adopted, and NQF is the place to watch.” How did that happen? “There was a strong belief on the insurance side of CMS that the only way to achieve efficient care is to achieve better care,” Clausen said.
- Laura Adams, president and CEO of the Rhode Island Quality Institute, confessed she was going through a Wendy’s drive-in when she had an “Aha!” moment. She realized the fast-food chain had more effective IT in place for ordering a burger than most health care providers have for patient care. Adams said her state is working hard to link all physicians, hospitals and pharmacies. Noting that Rhode Island is only 35 by 45 miles in size, with 1 million people and 13 hospitals, she said, “If we can’t do it here, we should be slapped.” By the way, two weeks ago 100 percent of Rhode Island’s pharmacies were connected to a patient record.
Adams also noted that some studies have come out recently questioning the value of health IT, including one proclaiming that EHRs have not been shown to affect quality of care. “Well, of course not,” she said, rolling her eyes. “We’re at 4 percent adoption in this country. And they’re not connected to each other.” Those studies are not only premature, Adams said, they’re also dangerous because they could discourage progress on HIT.
- Paul Hamnett, IHI vice president of engineering, quoting President Obama: “We don’t have excellent health care, we have islands of excellence. Let’s figure out how those islands do it.”
Bill Santamour, managing editor of H&HN, is blogging from the IHI conference.
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