Paper Kills

The following article was adapted from the text of Speaker Newt Gingrich's introduction to Paper Kills: Transforming Health and Healthcare with Information Technology. Edited by Center for Health Transformation Project Director David Merritt, the new release from CHT Press features a collection of insights from many of the leading minds in the healthcare and health information technology fields, including providers, vendors, payers, government officials, and renowned scholars. The book includes discussion of such diverse issues as privacy in confidentiality, optimizing health IT in order to support early health, and the potential of health IT to advance clinical research and the adoption of best practices. (Release date: June 4, 2007; available at www.paperkills.net.)

When I wrote Saving Lives & Saving Money four years ago, I outlined a future in which all Americans will live active, longer, and healthier lives. This future can be achieved because the people will be at the center of a healthcare system that has been designed for them. From their doctors and hospitals to their pharmacies and insurers, every aspect of the system will be designed to maximize their health in an effective and efficient way.

In tomorrow's healthcare system, all Americans will have access to the care that they need--and everyone will have the ability to pay for it. All Americans will be empowered to make responsible and informed decisions about their own health and healthcare. Early health, prevention, and wellness will be at the core of delivery. Treatment decisions will be based on effectiveness, and reimbursement will be driven by outcomes. Consumers will own their personal data and have a right to know the cost and quality of the treatments they receive and the providers they visit. Innovation will be rapid, and the dissemination of knowledge will be secure and in real time.

All of these are fundamental changes from today's approach to healthcare. Embracing these values is absolutely necessary in order for us to build what we at the Center for Health Transformation call a 21^st Century Intelligent Health System. Health information technology is the key to getting there.

I often ask people: when was the last time you took out a pen, wrote a check for cash, and handed it to a bank teller? Most young people today have no idea what "writing a check for cash" means because online banking, debit cards, and a global ATM network is the only world they've ever known. Unfortunately, that kind of technology and that kind of reality has yet to reach healthcare. And we pay a very dear price for it.

To put it simply: paper kills.

You show me a paper medical record, and I'll tell you about the 44,000 to 98,000 Americans who are killed every year by preventable medical errors. You show me a paper prescription, and I'll tell you about the more than 7,000 Americans who die every year from unnecessary medication errors. Paper processes are not solely responsible for these deaths, but they are the eroding foundation of a broken system.

Legions of experts--from scholars to practitioners to the Institute of Medicine--have repeatedly and consistently said that information technology and a modernized, interoperable health system are absolutely vital to preventing these kinds of errors and improving the delivery of care.¹ And study after study--as well as thousands of actual installations--concludes that information technology and an interoperable system will save massive amounts of money every year.²

To see these benefits, we must move quickly to adopt a unified set of open interoperability standards for data exchange. Open standards will lay the foundation for a nationwide health information network by allowing everyone to use common technical platforms, architectures, and vocabularies. From there, entrepreneurs will introduce a breathtaking array of solutions that can plug in to this network and share data. New technologies can run on a variety of platforms, including cell phones, monitoring devices, and the Web. These platforms will allow physicians, providers, and other stakeholders to plug in and share information, delivering better care at lower costs.

A unified set of open interoperability standards has been achieved in other industries. The creation of the Internet is a good example to highlight. In his excellent book The World Is Flat, Tom Friedman details how the private sector collectively agreed upon open data standards for the Internet, so that every system spoke the same language. Prior to these open standards, proprietary systems blocked the kind of collaboration and data exchange that we now take for granted. But over time, programmers, vendors, and solution providers worked collaboratively to develop open standards and a common communication framework. This integrated playing field gave rise to the modern Internet and all its marvels, allowing the private sector to compete on service, functionality, and quality.

That is exactly what we need in healthcare.

The Health Information Technology Standards Panel (HITSP), a group charged by the federal government to develop interoperable data standards, has made great progress. However, HITSP is taking its direction from the American Health Information Community (AHIC), a political body that has tried to be all things to all people. AHIC must focus on the real-world data exchange needs of physicians and other providers. Furthermore, the federal process has burdensome rules regarding what it can and cannot allow, but the private sector has no such constraints. The private sector has the ability to be bold and move quickly.

The private sector can and must deliver new solutions to break through industry paralysis and bureaucracy at all levels. The National ePrescribing Patient Safety Initiative (NEPSI) is one example. Led by Allscripts, Microsoft, WellPoint, and others, NEPSI offers safe, secure, and free electronic prescribing to every physician in the country. Another example is the collaboration between America's Health Insurance Plans and the Blue Cross Blue Shield Association and the creation of an interoperable, payer-based personal health record, where claims data can follow consumers as they move from insurer to insurer. Other groups, such as the Electronic Health Record Vendor Association, made up of leading innovators such as Siemens, GE Healthcare, and Misys, have put out roadmaps to interoperability, and have worked to implement these solutions with organizations such as Integrating the Healthcare Enterprise.

Through mutual and equitable collaboration, AHIC can work with the best of the private sector to develop bold solutions that solve the most important needs of data exchange and the most pressing problems in healthcare.

Three years ago, when David Brailer began his service as the nation's first National Coordinator of Health Information Technology, there was a real sense of hope and optimism that we as a country were coming together with a common vision. David did a magnificent job of articulating that vision and rallying industry and government around a common goal.

Now that we have embarked on the difficult journey to realize that promise, we must always keep the American people at the forefront of our thoughts. Americans are demanding a 21^st Century Intelligent Health System. They could not care less which data standard will be used, or how many representatives a stakeholder has on this or that council, or which bureaucrat will be appointed. What Americans really care about is a system that saves lives and save money--period.

On behalf of the entire nation, I make this appeal to every stakeholder in healthcare: put the pettiness aside, focus on the common solution, and do what is right for America.

Your country is counting on you.

Allscripts, America's Health Insurance Plans, Blue Cross and Blue Shield Association, GE, Microsoft, Misys Healthcare, Siemens, and WellPoint, Inc. are members of the Center.

The Center for Health Transformation, founded by former U.S. House Speaker Newt Gingrich, is a high-impact collaboration of private and public sector leaders committed to creating a 21^st Century Intelligent Health System that saves lives and saves money for all Americans. The Center helps create and accelerate the adoption of transformational health solutions that will give all Americans more choices of greater quality at lower cost. For more information, visit www.healthtransformation.net.

CHT Press is the publishing division of the Center for Health Transformation and was established in 2006 with the release of "The Art of Transformation," written by Newt Gingrich and CEO Nancy Desmond.

¹Institute of Medicine, Committee on Quality of Health Care in America, Crossing the Quality Chasm: A New Health System for the 21st Century (Washington, DC: National Academy Press, 2001).

²R. Hillestand et al., "Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings and Costs," Health Affairs 24, no. 5 (2005): 1103-17.