The Healthcare Industry in Usa

The healthcare industry in USA has been trying to fight the dual challenge of cost control and quality improvement. There is an emerging consensus that healthcare is an information and knowledge-intensive enterprise and the future of health industry depends on effectively implementing information technology to collect, manage, analyze and disburse the pertinent information and knowledge. Partners Healthcare Systems (PHS) was one of the pioneer companies to maintain a centralized digital records library of more than 4.6 million patients augmented in real time made available to the physicians and researchers. PHS was established by partnering Brigham and Women’s Hospital and Massachusetts General Hospital to produce an integrated health care delivery system that offered patients a continuum of coordinated high-quality care.

The National Academy of Sciences has observed that the persistent problems in healthcare is not because of the incompetence of the professionals but rather a consequence of the complexity of the system. With the assumption that organized systems lead to solutions and keeping the goal of quality improvement and cost control, we propose a few modifications to the emerging transformational health care delivery through Electronic Medical Record (EMR) and Computerized Patient Order Entry (CPOE) and analyze the potential risks. The transformation is classified into five scenarios based on their function.

The I2B2/National Center for Biomedical Computing utilizes the 4.6 million patient record as a resource for tracking and studying specific medical therapies facilitating the study of the response of a genome to a medication or therapy. This lowers the research cost substantially by making valid inferences through the cross functional use of the same data, as opposed to spending millions of dollars on new experiments. This system helps determine the favorable drug use outcome, avoid drug ineffectiveness, direct new drug development, lower cost and risk of drug development and administration.

This system has enormous unused potential. First, integrating this system with other bioinformatics and medical informatics databases would provide valuable data for biological and medical research. For example, if this system can be integrated with medical research website like NCBI, then the specific genes that are involved in certain kinds of diseases can be easily characterized. If the information can be sorted by features like sex, age, ethnicity, etc. it would provide further insight. Several research institutions in Europe provide similar services but we could not find a counterpart in USA. We feel that such data with research interest would attract federal funding or other endowments thus enabling them to further reduce the cost. A major risk is that untrained researchers working on such metadata could make invalid inferences. For this reason several scientists still believe in getting primary data as opposed to