WASHINGTON -- At its annual conference in Washington, D.C., this week, the eHealth Initiative announced a change in focus. Starting this year, eHI plans to concentrate on the role health IT can play in addressing chronic diseases. Specifically, the organization will target cancer, diabetes and heart disease.
eHI CEO Jennifer Covich Bordenick said that after 10 years, it's time for the organization to "sharpen our focus." She told iHealthBeat, "Focusing on chronic diseases is a natural progression of the mission of the group; it brings us one step closer to the end goal." She added, "We are not just talking about technology for the sake of technology. If you want to greatly impact the cost and quality of health care, you must focus on the deadliest and costliest diseases."
Covich Bordenick said reaction from members and other health IT stakeholders about the group's new focus "has been overwhelmingly positive." She said, "When you talk to physicians, patients and providers they get it: You can share social media technologies with cancer patients that help them better understand their disease, highlight apps that doctors can recommend to patients to manage diabetes [and] identify gaps where vendors can develop analytical tools that identify patients at risk for heart disease."
Covich Bordenick said, "It is not a hard sell; it just makes sense."
While speaking at the conference, Carolyn Clancy, director of the Agency for Healthcare Research and Quality, commended eHI on the change. She said, "I think the focus is fantastic."
Clancy noted that the 2010 National Health Care Quality and Disparities reports found that care quality improvement remains suboptimal and that access to care is not improving. She said that few disparities in care quality have been reduced and that nearly no disparities in access to care are getting smaller. Clancy added that cancer screening and diabetes management remain particular problem areas.
Clancy said, "We can do a whole lot better than this." She noted that "health IT has been front and center" in AHRQ's priorities and often is tied to patient safety efforts.
Clancy said that if the country is able to address diabetes, heart disease and cancer, there is no limit to the power of health IT.
Micky Tripathi -- president and CEO of the Massachusetts eHealth Collaborative and chair of eHI's Board of Directors -- said that although eHI's work now will target improving outcomes in cancer, diabetes and heart disease, it is important to "always be mindful of the extrapolation we can do to other disease categories," like multiple sclerosis or mental health.
At the conference, physicians, payers and patients discussed how health IT tools can help improve care, increase efficiency and reduce costs in the treatment of cancer, diabetes and heart disease.
Covich Bordenick said, "The industry has spent a lot of time talking conceptually about transforming care. Now we want to talk practically about what doctors and patients can do right now that works."
Health IT as a Tool for Physicians
Jack Lewin, CEO of the American College of Cardiology, said that health IT is a critical tool for cardiologists, noting that it can help increase care coordination and improve outcomes. He said electronic health records, mobile apps and secure physician-patient email can help cardiologists stay in touch 24/7. He added that data registries can help cardiologists measure and improve their performance.
Nancy Brown, CEO of the American Heart Association, said that "e-health technology is transforming the way health care is being delivered in this country." She explained that remote monitoring tools allow health care providers to constantly monitor their patients and adjust medications as needed.
Brown said that a home blood pressure monitoring program at Kaiser Permanente Colorado found that patients who used AHA's Heart 360 home monitoring program were 50% more likely to have their blood pressure under control than patients who monitored their blood pressure through physician office visits. She also noted that technology now allows health care providers to remotely and more quickly assess patients having a stroke -- the fourth leading cause of death.
Ileana Piña, a cardiologist at the Montefiore Medical Center in Bronx, N.Y., said EHR systems allow health care providers to share information about patients even when communication between doctors isn't where it should be. She added that health IT tools can allow physicians to educate patients better and could lead to early interventions.
Len Lichtenfeld, deputy chief medical officer at the American Cancer Society, said progress has been made in cancer treatment and detection, but "we're not there yet." He said that the technology exists to improve cancer care but that the lack of standards in cancer communication is a significant barrier.
Lichtenfeld said, "We are doing things like Neanderthals," adding that to deliver on the promise of health IT, there needs to be a strategy on how to link information. Lichtenfeld also encouraged health care providers to embrace social technologies and "go where patients are."
Health IT as a Tool for Payers
Robert Greene, vice president of Clinical Analytics at UnitedHealthcare, said that as an insurer, United's goal is better health, better care and lower costs.
Greene noted that health plans have access to a huge amount of claims data. United uses that information for transparency programs, benefits design and other reform-related efforts. He said, "We strongly believe that both physicians and patients need this information."
Greene said that health information exchange could help create a consolidated database that would allow insurers and others to better understand variations in care, which might lead to better outcomes and lower costs.
United also offers incentives to encourage patients to become more engaged in their care, according to Greene. For example, if patients input data into their personal health records or comply with their diabetes management plan, their premiums are lower.
Health IT as a Tool for Patients
According to government data, more than 133 million U.S. residents, or about 45% of the country's population, have at least one chronic condition. While doctors' and insurers' use of health IT could lead to care improvements, many experts say that patients' engagement in their own health and health care is the true key to addressing chronic diseases.
Daniel Treadwell, a cardiac patient, said there are "no better resources than the patients themselves."
Talking about his experience undergoing an aorta valve replacement in 2007, Treadwell said, "Knowledge is power, and I wanted to learn as much as I could before my surgery." Treadwell said the Internet has made it much easier for patients to become engaged in their care. In addition to researching the benefits and drawbacks of mechanical versus tissue valves and the different brands of valves, Treadwell participated in online forums where he connected with other patients who had gone through similar experiences.
More and more patients, especially those with chronic conditions, are turning to social media and other tools for health-related purposes.
Daniel Garrett -- partner and health IT practice leader at PricewaterhouseCoopers -- said PwC Health Research Institute's 2011 Consumer Survey found that:
- Nearly one-third of consumers have used social media for health care-related reasons;
- 22% believe the use of social media for health-related reasons will increase next year;
- 38% said that a hospital's social media presence would at least somewhat affect their decision to receive treatment at that facility; and
- 54% would be comfortable with doctors going to online physician communities to discuss patients' health to improve treatment.
Regan Minners -- managing director of Diabetes Prevention, Youth and New Patient Programs at the American Diabetes Association -- said that social media and mobile apps can be leveraged to encourage patients to engage in moderate lifestyle behavior changes that can reduce diabetes costs and help prevent the development of Type 2 diabetes.
She noted that 73% of U.S. residents visit Facebook each month and that 83% of adults own cellphones and half of them have mobile applications on their phones. Minners said that research has shown that e-health works but patient motivation is key.
Minners noted that there are more than 7,300 health-related apps in the Apple store. She said that while some of the apps -- like those that track users' body mass index or help users stay on track with their fitness routines -- seem promising, others -- like "Slim While You Sleep" or "Lose 10 Pounds in 10 Days" -- are less realistic. Still, she remains optimistic about the potential of leveraging e-health to reach out through social networks, noting that prevention can be contagious.
Harold Freeman -- president and CEO of the Harold P. Freeman Patient Navigation Institute -- warned that it is important not to forget about underserved patients who might not have access to computers or other technology. He said, "Nothing beats person-to-person contact," but electronic tools can augment that relationship.