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If you're rushed to the hospital, how quickly can they get your medical records? In these days of high tech, you'd guess minutes, right? Especially since a few minutes can make the difference between life and death. Here to explain the challenges our healthcare system faces, and the changes being made to add "value" to the system, is Dr. Ronald Savrin, medical director of Ohio KePRO.

Question: We call it our Health Care system. But do we really have in integrated system?

Answer: As a physician, I assure you doctors, nurses, hospitals, nursing homes and other medical professionals and facilities provide the medical care we need - but do they form a "system"? Perhaps not - in fact, in some ways America lacks a health care system. What we have is loose network of poorly connected practitioners and facilities operating independently.
Think about our phone "system". Phone companies have developed an interoperable system wherein you can pick up a phone from a cell phone company and talk to a friend with a phone from another company. And when you chose a phone company - land line, cellular, or internet - you examine interoperability, quality and price and select the best option for what you want. These are the cornerstones of the system. All of these things are missing in our current health care system.

Question: What happens when we have an information disconnect between patients and providers?

Answer: If you get sick in Los Angeles and your medical records are in Cleveland that information is NOT exchanged easily. Even if both facilities have an electronic health record - they probably cannot communicate with each other. Your health, your life, may depend on that interoperability. Without, you may not get the quality care you need.
We need to create industry wide standards and we need to implement the technology infrastructure to support such information transfer.

Question: Let's switch gears a little.  We can, as you suggested, compare quality between phone companies. How do we do that for medical care providers?

Answer: First, we need to decide what constitutes quality. For a phone company it might be coverage, voice quality, and reliability. So with health care, we need to first define quality standards that we all agree upon - like controlling blood pressure or giving antibiotics just before surgery.
After those quality standards are chosen we can measure how often they are followed. At this point, we can share this information with consumers, the patients. This sharing is called "transparency."

Question: When we sign up for phone service we do, in fact, know what the cost will be. But most Americans have health insurance – or Medicare or Medicaid– so why is price important?

Answer: Price is critical if we are to make informed decisions. Beyond the cost of our insurance, none of us has a clue what we actually pay for health care. When someone goes to the emergency room with a headache, it costs a lot more than going to the doctor's office. Even if we have insurance, we pay for it in higher insurance premiums and co-payments, lower wages, and higher priced goods and services. We would not buy a car, or a house, or a television without knowing the price. Some expensive treatments may be worth it, others may not be. We need the information to decide.

Question: Once we have quality and price information, how do we use this information to create a better system?

Answer: A Value Driven Healthcare System will use this information. The better the quality and the lower the cost, the higher the value.
When you buy a car, you don't care how many hours of labor it took to build or how much steel it took - you care about the quality and the price of the car. Presently, healthcare expenditures are based on the amount of services received and the resources utilized - not the value received. We need to provide incentives to increase quality and decrease cost. We need to reward providers who deliver, payers who offer, and patients who select cost-effective high-quality care. We know the cost and quality of our cars. The same should be true of our healthcare.

To learn more about value-driven healthcare, call Ohio KePRO at the number that's next, or check out the link on their website. My thanks to Dr. Ronald Savrin.