This report originally appeared in the March 2010 issue of DOTmed Business News

This issue displays again the great promise of information technology as a cure for our health care dilemmas, those dilemmas dealing with cost, quality and access. The Obama administration and even the unlikely bedfellows of Hillary Clinton and Newt Gingrich have all touted electronic health care records (EHR) as a chief example of a strategy to reduce errors, duplication and cost. Now, federal funds are earmarked to encourage wide adoption by providers.

But why are stimulus funds necessary to encourage adoption? In his blog, Robert Teague asks that question. He also offers a sensible answer, "The truth is, for clinical purposes, they don't work."
Lorraine Fernandez, VP of Initiate Systems,, in her article, "Electronic health records: New road leading to bridge to nowhere?" expands further. She writes, "The key is not necessarily the EHR, but the ability to connect a variety of health care organizations so that there is one, accurate EHR that facilitates patient-centric, coordinated health care."

Coordination in our byzantine system will be a challenge. The president of an Integrated Physician Network in Colorado, who is chasing "meaningful use" of the EHR with his physicians, recently noted that much of medical care happens in the doctor's office, detached from hospitals. But those offices often resemble the doctor's offices of the 1950s, complete with paper charts and test results buried in a file, unseen, untrended, unknown to the patient and complementary providers.

But do GPOs have a role? They have sniffed around the edges of IT solutions, most of which are geared towards reducing cost or improving revenue. Supply data base cleansing, pricing accuracy, and revenue cycle management seem to be on every GPO's agenda. But the casual addition of an IT product or software in their portfolio, a passive offering at a fuzzy "discount," is absent any discernible impact.

A MODEST PROPOSAL

In spite of the valiant GPO efforts to reduce them, overall health care costs continue to escalate, seemingly beyond anyone's control. Realistically, GPOs cannot control American demographics, or muster voice enough to influence reform, but what about two areas unexplored?

WASTE AND FRAUD

CMS, perhaps too hopeful, expects widespread adoption of EHR to assist in weeding-out payment inefficiencies and reducing Medicare and Medicaid fraud. Those two entities only made $54.2 billion in erroneous payments in the last fiscal year, according to the White House's Office of Management and Budget. That total swamps the savings GPOs claim in recent studies. In fact, according to the National Health Care Anti-Fraud Association, the total defrauded each year is closer to $120 billion.

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