Gazette Opinion: VA leads nation in IT for better patient care

2010-04-09T00:00:00Z Gazette Opinion: VA leads nation in IT for better patient care The Billings Gazette
April 09, 2010 12:00 am

New high-tech medical treatments continually advance care options (and costs) for Americans. However, when it comes to one area of technology use, the health care industry nationally lags behind most others.

Information technology that has revolutionized other business fields is still in its infancy in the U.S. health system.

An exception is the Veterans Affairs health system. That difference allowed the VA to save billions of dollars over the past decade, according to a study published this week in Health Affairs.

The study, authored by Colene M. Byrne and five colleagues at the Center for IT Leadership in Charlestown, Mass., estimated that VA’s IT investments had saved $3.09 billion net of costs.

How did that work? The researchers evaluated these components of the VA IT system:

• Computerized patient record system, which reduced inpatient and outpatient costs for preventable adverse medication errors, avoided influenza and pneumonia, reduced redundant and unnecessary lab and radiology tests, and reduced time clerks spent pulling charts.

• Picture archiving and communication system, which reduced radiological film supply costs.

• Bar code medication administration, which reduces inpatient costs for preventable adverse drug events caused by inpatient medication errors.

• Laboratory electronic data interoperability, which reduced time VA lab techs spent on order processing.

To measure the quality of VA care and compare it with the private sector, the researchers focused on diabetes care. About 25 percent of VA patients have diabetes and the VA computerized patient record system has several diabetes-related quality measures.

The researchers said they derived a conservative estimate of VA savings through their cost-benefit analysis. During 2001-2007, VA spent relatively more on IT than did private sector health care providers. VA put more of its total spending into IT, more of its capital spending and more of its operations and maintenance spending, the researchers found. Altogether, the VA spent $4 billion on IT during the period, but as a result, saved $7 billion over what the researchers estimated it would have spent without the electronic information system. The researchers estimated that 65 percent of all savings was derived from preventing errors in medication.

Like previous studies, the IT group found that VA did better than the private sector in preventive care measures such as cancer screenings, flu shots, and management of chronic diseases such as diabetes and heart failure. The IT system includes electronic clinical reminders for VA providers to perform preventive care.

The authors questioned whether the VA success can be fully replicated in the private sector. The VA is one, nationwide federal agency; the private health care sector consists of thousands of public, private, nonprofit and for-profit entities large and small.

However, confirmation that IT can result in significantly better and consistent high-quality care should encourage private health leaders to adopt it.

The American Recovery and Reinvestment Act of 2009 included substantial funding to encourage private providers to implement health IT and federal health programs are incorporating incentives for providers to use IT.

The research on the VA indicates that IT done right can be an excellent investment for controlling costs while improving patient care.

As Secretary of Veterans Affairs Eric K. Shinseki said in a news release this week: “The benefits have exceeded costs, proving that the implementation of secure, efficient systems of electronic records is a good idea for all our citizens.”

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