Jane MetzgerHCI: The fact that VTE prophylaxis is involved in both meaningful use and value-based purchasing under healthcare reform is significant, of course.Metzger: Yes, and it speaks to the fact that the traditional approaches won’t work, and won’t be the basis for thriving as patient care organizations. It’s going to take real assertiveness on the part of healthcare leaders to move into this new environment.HCI: Health information technology and healthcare reform are essentially moving in the same direction when it comes to developing innovative ways to track patient status and intervene in a timely way, correct?Metzger: Yes, and the examples we picked are particularly pointed, because they both speak to the fact that there are bad things that can happen to patients that are preventable, and part of providers’ responsibility will be to prevent those things—sepsis and VTE that develop in hospitals are great examples. These two examples have to do with fundamental elements of patient safety, and with really being on top of things, so that these often-avoidable things are in fact avoided; and that’s why we picked those two, because they’re pretty hard to shove down lower on the list of the things we should be doing.HCI: What should CIOs and CMIOs think, when reading this report?Metzger: First, there’s been this tendency among many in the industry to think that, collectively, we’ll do everything we have to do when we’ve reached some kind of end-state and have all the data we need. I think one of the takeaways here is that that’s not the kind of thinking that will maximize of the value of all this data infrastructure. Honestly, I think we’ll think the data will have some imperfection, forever; so it’s not tomorrow’s data, it’s today’s data. But it may take a different kind of thinking, and it may take some enhancements to the technology.The second I would say is that the expectations of the world at large, among the policymakers, the payers, the public, around preventing untoward things that can happen—and all that is now tied to money, not just reputation—really mean that the whole game is now about superior performance, all the time. And basically, it’s going to take this kind of proactive, real-time intervention-based approach to accomplish those things [and improve patient safety].And really, it’s in this way that all the lofty goals of the HITECH Act and other things going on are going to actually be realized. What we’ve tried to do with this white paper has been to paint a picture and suggest how we need to start thinking about it all differently, and developing the care processes and the IT to support this kind of work. But I think this is where we were always headed. It’s just that, now that we’re closer, and the environment has ratcheted up expectations so much, we’re at a point where we can visualize it better.
