Health Info Tech: Think Bigger, Dennis

KELO gives some thin weekend reporting on the state's efforts to make more use of information technology to streamline health care, specifically in the handling and sharing of medical records. The news blurb [Gina Weber, "Task Force Looking to Use Internet for SD Health Care," KELOLand.com, 2007.07.15] says "Lt. Governor Dennis Daugaard chairs the task force" but doesn't actually name the task force. I assume the task force is the Zaniya Project, although Lt. Gov. Daugaard certainly has the acumen to chair more than one task force at once....

Reporter Gina Weber says that Daugaard says "an online patient history system is doable, but is years away yet" [direct quote from Weber, not from Daugaard himself]. Um, actually, here's another example of how the Zaniya Project ought to look overseas for examples of how to do health care right. A 2006 study [Gerard F. Anderson, Ph.D., Bianca K. Frogner, Roger A. Johns, M.D., Uwe E. Reinhardt, Ph.D., "Health Care Spending and Use of Information Technology in OECD Countries," Health Affairs, May/June 2006, summarized by Linda Prager and Deborah Lorber, CommonwealthFund.org, 2006.05.10] notes that the US is already a dozen years behind other countries in using informtion technology, even though in 2003 the US spent two and a half times as much per capita on health care as the median for OECD countries. According to the handy chart at the bottom of Prager and Lorber's summary, even those pesky socialist Canadians outperform us, spending a cool billion to put information technology to work in health care versus the United States' paltry $125 million (the per capita figures are even more embarrassing: $31.85 on health care IT per Canadian versus $0.43 -- that's 43 cents -- on HIT per American). Canada initiated its national HIT program in 1997, as did Norway. The Germans, models of efficiency, beat everyone to the punch, starting their national HIT effort in 1993. Australia got to it in 2000, the Brits in 2002. And the US, leader of the free world, home of all the most cutting-edge technology? We just started last year.

Hmm... so maybe the difference is that Canadians, Norwegians, Germans, Brits, Australians, and all the other civilized societies of the world see new technology and immediately think, "Ah! Let's use this to promote the common good!" while Americans see new technology and immediately think, "Hey! Let's make a bunch of money with this!"

Whatever the causes of America's laggardly development of HIT (maybe insurance companies are able to increase profits through an inefficient paperwork system that makes it easier for them to hide their mistakes, denials, and profits?), it's unbelievable and unconscionable that South Dakota, a leader in Internet access and application of technology to education, hasn't led the way in developing a comprehensive HIT system by now. If an online medical records system is a dozen years away, it's only because of a lack of focus, not technology. With our tech know-how and resources, we should be able to catch up with Canada, Germany, et al. in no time.

Interestingly, HB 1169, the 2007 legislation that created the Zaniya Project, says nothing about looking into HIT: "The task force shall develop a plan, complete with action steps and timelines, to provide health insurance to South Dakota residents who lack health insurance coverage. The task force shall seek to create efficiencies in the purchase of health insurance products." That language doesn't on face include a charge to create efficiencies for doctors in treating patients.

But hey, if the Zaniya Project is interpreting its mission as broader than merely expanding access to (or mandating the purchase of -- keep that Massachusetts plan away!) health insurance, then maybe South Dakota's health care Dennis can think bigger than the paltry mandate of HB 1169. maybe he should call the don of health care Dennises, Ohio Congressman and Presidential candidate Dennis Kucinich, and get the straight poop on a health care system that would lower health care costs and expand access to everyone. Think big, Dennis! A proposal for real health care reform might make you a sure bet for governor in 2010!