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called comparative effectiveness research a "diversion" from what he sees as the true goal of continuous healthcare quality improvement, but be believes another major U.S. government health IT initiative is on the right track.
"I think Meaningful Use is directionally very correct," Halvorson said of the national electronic health records (EHR) incentive program. "I think [federal health IT leaders] need to continually improve it because I don't think it's a done process, but it's directionally very correct," Halvorson told InformationWeek Healthcare in a recent interview.
The 2009 American Recovery and Reinvestment Act allocated $27 billion for the Meaningful Use program and an additional $1.1 billion for the Agency for Healthcare Research and Quality (AHRQ) to conduct comparative effectiveness research. (AHRQ has recently backed away from the term "comparative effectiveness" in favor of "outcomes research.")
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"One of the nice things about Meaningful Use and the money is that a lot of healthcare organizations that would not have computerized have now gone down that path. Because they have, we now have an infrastructure that we can work with," Halvorson explained in an interview. Halvorson delivered a keynote address at the pan-European World of Health IT conference in Copenhagen, Denmark, this month, then spoke to InformationWeek Healthcare at the official residence of the U.S. ambassador to Denmark, Laurie Fulton.
EHR technology can help support the patient-centered medical home model, which Halvorson called "an important innovation" to emphasize prevention of chronic diseases and comorbidities for patients who already have chronic conditions, though it can take a hefty investment.
"The medical home is much more likely to succeed now because all of those care sites [that have installed EHRs] have computerized data. The medical home in a paper database is really hard. Medical homes in a computerized database is much easier," the Kaiser CEO said.
While Halvorson said Meaningful Use has U.S. healthcare providers headed in the right direction, he would like to see more emphasis on interoperability of EHRs and other electronic health data between healthcare organizations. "We need a way to make those systems talk to each other," Halvorson said, invoking the ease with which the banking industry can exchange data.
Kaiser's core EHR, called KP Connect, is from Verona, Wis.-based Epic Systems, which has taken heat from some quarters for supposedly not being committed to interoperability with technology from other vendors. But the onus really is on EHR users--healthcare providers--to cooperate with their competitors, according to Halvorson.
He noted that Kaiser has joined with other large integrated health networks including Geisinger Health System in Pennsylvania, Mayo Clinic in Minnesota, Group Health Cooperative in the Pacific Northwest, and Intermountain Healthcare in Utah, to promote standards-based information sharing even though much of their technology relies on proprietary databases.
Sometimes, competition needs to take a back seat to care improvement, which is why Kaiser recently offered all of its HIV care protocols to the nation for free."Our belief is that we will do better if everybody else performs at a higher level," Halvorson said.
"Some people think of care protocols as being a competitive edge," Halvorson explained. He believes it is fine to remain secretive about some processes related to patient satisfaction, but that it is wrong to protect knowledge that might keep people alive. "We know how to keep people from dying of sepsis. We feel a compulsive need to share that. But there are other places that have figured that out themselves in the past who haven't shared it with anyone, which is unfortunate."
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