This week I'm in Tokyo meeting with Japanese government officials (legislative and executive branch) to share lessons learned from US Healthcare IT stimulus efforts and plans for healthcare reform, including the IT implications.
Although the Japanese are much healthier than Americans, they have their own healthcare challenges. Japan has an aging society, a low birth rate, disparities of care across income levels, and rising costs. Since reimbursement is largely via government funded programs, the imbalance of those seeking care and those paying into the system will create a crisis of rising costs over the next decade. Here's a news story from the Japan Times that illustrates the problem.
Hospitals are typically not connected to the internet because of privacy concerns. Data is rarely shared with patients or among providers because of misalignment of incentives. IT adoption among hospitals is highly variable.
My message to the Japanese is that healthcare IT is one tactic that can help.
Using electronic health records provides a foundation for quality measurement, decision support, and exchange of healthcare data for coordination of care. Incentives need to be realigned to focus on quality and outcomes rather than fees for services rendered. Privacy policy needs to be formulated that protects confidentiality and patient preferences but also enables collection and exchange of data that fosters wellness by encouraging the right care at the right time. The excellent work in error reduction that has permeated Japanese industry needs to be applied to healthcare. At present, Lean/Six Sigma approaches have not been applied widely to hospital care.
A healthcare IT Stimulus program for Japan, incorporating lessons learned from ARRA/HITECH is a good first step. By deploying technology and creating policy in parallel, the Japanese can innovate in healthcare, reducing costs and improving quality.
The article from the Japan Times is actually a boost for the comparison research currently advocated by our Health Care Law. There was a debate whether expensive chemotherapy resulting in few successes should be funded without very careful scrutiny. It seems a very rational discussion to have.
ReplyDeleteBefore we can offer our technological advice to Japan, we must admit at this point it is still unproven as a program to reduce costs or save lives.
We need to weed out our affordability and access problems solved first before presenting solutions are still in the beta stage to the rest of the world.
Hopefully we will get there but before the die is cast, let's see if it works first.