June 22nd, 2009

Health Information Technology: Why is it important to Portland?

Health Information Technology: Why is it important to Portland?

[Editor: Health Information Technology has always had a interesting spot in the Portland startup scene. And I say that, most likely, because I've been part of it from time to time. But I'm probably not the best person to write about it. Enter Bill Hersh, MD, Professor and Chair of the Department of Medical Informatics & Clinical Epidemiology (DMICE) in the School of Medicine at Oregon Health & Science University (OHSU) in Portland, Oregon. Here's his perspective on HIT, its role, and its potential for the Portland tech scene.]

I appreciate the opportunity to contribute a piece to this blog about a topic of great interest to myself and many others, which is health information technology, also called health IT or HIT.

Those of you who work with IT every day may be wondering, what’s the big deal about health IT? Why can’t health care find appropriate IT solutions to help solve its problems? Why is it necessary to have health IT be an explicit part of President Obama’s economic stimulus package?

In some ways, the inability to make best use of IT is symptomatic of the larger problems in health care. This is an industry that is uncoordinated, conflicted by a diversity of self-interests antagonistic to the greater good, and not amenable to normal market conditions (i.e., you don’t go comparison shopping when you have acute appendicitis).

But I cannot put all the blame on the health care system. The work of health care is not always congruent with IT systems that can be slow, unreliable, and not synchronized with the workflow of highly mobile multitasking individuals. Furthermore, IT professionals do not always understand the language or operations of health care. In addition, those who pay for the systems (especially small physician offices) are not always those who get the benefits (typically laboratories and insurance companies).

Much can be written about who is right and wrong here, but we need to go past that and aim for solutions that benefit patients and their health while developing solutions that do not adversely effect the work of health care professionals. To this end, the field of biomedical and health informatics has emerged, which crosses the chasm between health care and IT, and is led by highly trained individuals who understand and can speak both languages.

There are many reasons for health IT to be part of the economic stimulus package. There is growing evidence that health IT can improve the quality and safety while reducing the cost of health care. It can improve coordination of services provided. Health IT also can empower people to maintain and improve their health before they ever become patients, and it also has a strong role in the growing biomedical research enterprise. Finally, there is a financial mismatch between those who benefit and those who pay, so something must be done to facilitate its adoption.

So health IT is a big deal. Solutions will not emerge from the market alone, especially if meaningful health care reform is not achieved.

Health IT is also a big deal in Portland. Many of the regions larger health systems (e.g., Kaiser, OHSU, Providence, Legacy, etc.) already have advanced electronic health records and other systems in place. Portland has many companies large (Intel, IBM, WebMD) and small (Kryptiq, Collaborative Software Initiative) that are active or poised to be so in health IT.

Portland is also home to one of the largest and longest standing academic programs in the biomedical informatics field at Oregon Health & Science University (OHSU). Let me start with the disclaimer that I am the Chair of the OHSU Department of Medical Informatics & Clinical Epidemiology, where that program is housed. However, I have long taken an outward-looking view and advocated that Portland could become a hub for health IT at the intersection of industry, academia, and its health care systems.

In other words, health IT can be good for Portland not only in improving its health care system but also playing a role in economic department. My department at OHSU, for example, is a $9 million “business” that derives most of its revenue from outside the state. We are very interested in seeing more academia-industry collaboration.

For more information

I would love to hear more from those who share this vision. I am easily reached via email (hersh@ohsu.edu). I also maintain an email list for those in the community interested in health IT, to which I am happy to add anyone

I recently published a paper that defines the terminology of the informatics field. I also have a web page with links and on-line lectures that answer the question, “What is Biomedical and Health Informatics?” I also have my own web page at http://www.billhersh.info/ and a blog entitled, the Informatics Professor. The web site for our program at OHSU is http://www.ohsu.edu/dmice/.

William Hersh, M.D. is Professor and Chair of the Department of Medical Informatics & Clinical Epidemiology (DMICE)American College of Medical Informatics and a Fellow of the American College of Physicians (ACP). Dr. Hersh has also served as Secretary of the American Medical Informatics Association (AMIA) as Chair of the ACP Medical Informatics Subcommittee. He is currently Chair of the International Medical Informatics Association (IMIA) Working Group on Education.

(Image courtesy sillygwailo. Used under Creative Commons.)

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