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Seeking the cure for health care

CEO advocate Bruce Mehlman warns that the national health care system is being undercut by an out-of-date information infrastructure.

Our national health care system is full of contradictions.

Advanced technology is available at all levels of care. Our doctors use magnetic resonance imaging, laser scalpels, smart drugs that pinpoint and destroy only cancerous cells, microscopic wireless cameras that patients swallow, and 3D ultrasound devices that assess fetal health. Surgeons can practice operations on virtual reality simulators, learning by doing but without risk to patient. Conditions that were once incurable are now mere outpatient procedures.

Yet it is precisely the ubiquity of these amazing innovations that highlights the glaring absence of more basic technology in so much of the rest of the health care system.

Your doctor, for example, may send you to a specialist with a $1.5 million CT scanner, but every time you enter each new office you are handed a clip board with pages seeking your printed name, address, insurance information and medical history.

Amazing new medicines are on the market, but whether they can co-exist in your bloodstream depends on whether each doctor was made aware of the other's prescription. And whether the pharmacist gives you Zoloft or Zocor depends too often on her ability to discern the physician's handwriting.

Our $1.8 trillion medical system depends on antiquated paper files and out-of-date customs to make it work.

Our $1.8 trillion medical system depends on antiquated paper files and out-of-date customs to make it work. And, too often, it simply doesn't provide the level of care you deserve, as evidenced by the dire estimate that preventable medical errors cause up to 98,000 deaths in the United States each year.

A key problem is that the health-care system is based on actions, not outcomes. By design, we pay for process and not performance, placing quantity over quality for purposes of reimbursements. Whether the surgeon botches the operation, fails to follow modern procedure or performs a minor miracle, she is paid the same by Medicare or insurance.

But an even greater challenge is the lack modern information infrastructure. The digital tools that have radically improved productivity and quality across our economy have barely touched health care, and it shows. While almost every sector of our economy is transforming itself through new IT-enabled processes (such as direct-to-consumer connectivity, real-time online access to critical information, and aggregation and analysis of detailed data), our health care sector remains characterized by islands of advanced technologies in a sea of paper.

We're letting down our doctors too. By keeping vital patient information out of their hands, we limit their ability to make the best medical decisions. By failing to automate prescribing and delivery systems, we subvert their intentions and confuse their instructions. By failing to collect information on quality and outcomes, we decline to provide them with the best data they could have about the results of medications and treatments, information that would help them save lives.

The good news is there is growing recognition of the problems and need for solutions. Key senators are now proposing bipartisan legislation to modernize our nation's health-care system. For all of the partisan bickering that goes on in Washington, the fact that Sens. Bill Frist, R-Tenn., and Hillary Rodham Clinton, D-N.Y., who could both be presidential candidates in 2008, have jointly introduced legislation on that matter speaks volumes about the importance of it.

Those two leaders have been joined by Sens. Chuck Grassley, Michael Enzi, Max Baucus, Edward Kennedy, Olympia Snowe, Christopher Dodd and Debbie Stabenow in proposing important changes that begin moving heath care from a quantity-based system mired in paper to a quality-based digital environment.

To their credit, lawmakers have risen above partisanship to define this issue as a priority. But there is much work remaining. Key players in the health care ecosystem need to work with Congress to identify the best sections of each of the bills introduced, developing consensus around the key measures.

In what promises to be a long, hot partisan summer, lawmakers will need to match their encouraging announcements with action.

The first test is now before us, as Congress considers whether to fully fund the federal agency spearheading government efforts. Last year Congress refused to provide any money for the Office of the National Coordinator for Health Information Technology, delaying its important work.

This year the President has requested $125 million for this critical office. We will soon learn whether Congress is serious about modernizing our health care system. These are votes that every American should be watching.