Publication Date: Wednesday, May 25, 2005
On Deadline: Top U.S. health official glimpses future of health care at Stanford, PAMF
On Deadline: Top U.S. health official glimpses future of health care at Stanford, PAMF
(May 25, 2005) by Jay Thorwaldson
Former Utah Governor Mike Leavitt, now the secretary of the U.S. Department of Health & Human Services, blew through Palo Alto Monday, visiting both Stanford University and the Palo Alto Medical Foundation.
His purpose was to glimpse -- and share his own vision -- of a major aspect of the the future of health care: Spell it IT, for information technology.
His conversations evoked memories of discussions nearly 15 years ago when I was an early member of a "Computer Committee" at PAMF, as public affairs director there. It felt like a whoosh of time from those early discussions with a handful of physicians to the same topics being discussed as national policies.
And it has been an expensive whoosh -- Van Johnson, president and CEO of Sutter Health, with which PAMF is affiliated, who came down from Sacramento for Leavitt's tour -- said Sutter has invested $154 million in information technology in recent years.
It's a good investment, he indicated, adding that IT advances such as those pioneered at PAMF are being expanded to all Sutter's 27 hospitals and 5,000 physicians.
Similar investments of various sizes are being made across America, from individual doctor offices to giant health care systems.
But the investment needs to be done with care and thought. Leavitt commented that he just visited medical facilities in Texas where three separate institutions have invested a combined $100 million or more in IT systems -- and none of the three can communicate with the others.
Leavitt was relaxed, friendly and conversational as he toured PAMF departments, chatting with patients, physicians, administrators and members of the Internet committee that has pushed forward online services for patients -- including access to their medical records and e-mail with physicians.
Earlier, he spoke at Stanford University Medical Center, discussing IT, Medicare, Medicaid and other facets of America's often chaotic health care system that since January he has been assigned to guide.
"It's a lifesaver," longtime PAMF patient Marianne Marx said of her online connection to PAMF -- sitting in a crowded exam room with her physician, Sal AbiEzzi, and a group of reporters and administrators. She said she could schedule appointments and do many other things online much more easily than in person.
Dr. AbiEzzi, an internist, said he now has about a thousand patients online and "can do ten times more" in terms of patient contacts. Early fears about being overwhelmed with e-mail from patients were unfounded, he said, adding that he gets only about four or five e-mails a day, many requiring just yes or no answers. But he emphasized that face-to-face meetings are still vitally important to good health care.
"I use it to manage my wellness," one patient, Anne Perlman of Palo Alto, said of the Internet service. She said it helps her remember when she needs a physical exam "when I turn one of those ages that ends in a 5 or 0," and she can consult with her insurance company and even patient-billing people.
A star of the visit was Keith Belcher, a longtime patient and retired trade show exhibit designer with offices in Palo Alto. Belcher, now retired, lives in Sweet Home, Ore., southeast of Portland. He said he travels frequently in an old motorhome he once used to show Russian Ridgeback dogs. He still has his Palo Alto physicians, he said.
He doesn't worry about getting access to his physicians or health records, he said.
"Whenever I go on a trip in my motorhome, I'm just an e-mail connection away from my medical records," plus e-mail access to his physician. He just registered for an RV convention where his will be one of 5,000 rigs -- all with wireless access to the Internet.
"Your RV thing sounds pretty good," Leavitt commented.
He said the key today is to improve "interoperability" between IT systems. "An ATM system for health care," with universal access to all systems, is how Johnson of Sutter described the need.
Security and privacy also is a high-priority concern, Leavitt noted in response to a question.
PAMF President and CEO David Druker agreed on the public's concern about confidentiality -- and security was one of the earliest topics of the old Computer Committee at PAMF.
"But we learned that the old paper medical records were not very secure," Dr. Druker said. Leavitt cited an old quip about "just ask any janitor" how secure the old medical files were.
Dr. Paul Tang, one of the PAMF physicians involved in early discussions, cited the "emphasis on privacy, so consumers can trust the system," as essential to the success of online medical records and health care.
Security and privacy "is a dilemma in every part of our lives" today, Leavitt concurred.
Editor Jay Thorwaldson can be e-mailed at jthorwaldson@paweekly.com.
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