Commentary: How California Can Lead in Health IT

Mark Smith, Founding President & Chief Executive Officer


This is archived content; for historical reference only.

Every major industry, with the notable exception of health care, has used information technology to make its services more accessible and affordable. Online check-in and self-serve kiosks have reduced costs and increased convenience in airline travel. Online banking and the widespread availability of ATMs have had similar results.

While the health care industry uses advanced technology to diagnose and treat patients, our medical records are still largely kept on paper. Even the nurse who uses a digital thermometer routinely scribbles the results on a notepad. How much confidence would you have if your bank still used paper ledgers to record your deposits?

This failure to innovate causes medical errors, poor patient experience, and higher health care costs, which contribute to the growing number of uninsured and threaten the state’s economy. It’s time to do something about it.

Governor Schwarzenegger instructed state agencies, by July 2007, to develop a business model and financing strategy for achieving a comprehensive health information technology (IT) plan. In October 2006, the state invited consumers, health care leaders, and others to participate in an eHealth Action Forum in Orange County.

The California HealthCare Foundation, an independent philanthropy based in Oakland, offered 10 recommendations for the eHealth Forum to consider:

  1. Give Californians timely and secure access to and control of their personal health information. Instead of having to wait weeks to obtain copies of paper medical records from doctors and hospitals, support a patient’s right to gain electronic access to their information and ensure that health privacy laws are up-to-date and enforced.
  2. Provide Californians with understandable and comparative information about health care quality and cost. This is feasible only if health care information is collected, stored, and analyzed electronically.
  3. Close the health IT gap. Californians who frequent community clinics, rural health centers, and small physician practices are much less likely to benefit from health IT. Invest in equipping these providers with the same capabilities available at large, urban practices.
  4. Develop an IT-savvy health workforce. As more physicians’ offices and hospitals are equipped with sophisticated information systems, we need to train doctors, nurses, office staff, and other health professionals on how to use them effectively.
  5. Develop a statewide emergency health infrastructure. One of the tragedies of Hurricane Katrina was the inability of patients to fill prescriptions lost in flooded homes and pharmacies. Let’s prepare California by creating a statewide lab and pharmacy backbone that can be expanded for other uses.
  6. Develop a statewide telemedicine system. Too often, rural Californians do not have access to the care they need. Let’s put in place a statewide, broadband telemedicine network to provide rural and other underserved communities access to the best medical care.
  7. Adopt national and state health IT standards. Doctors, hospitals, and insurers all have computers, but they often can’t talk to one another. Let’s require those who develop and purchase health IT systems to adopt uniform standards to promote the flow of secure information.
  8. Coordinate the State’s actions. The State of California is the largest purchaser of health care in the state. Better coordination is required among state agencies if California is to successfully direct and influence the adoption and effective use of health IT.
  9. Align public and private sector efforts. Government can’t do it alone. Create a mechanism for engaging the private sector in developing innovative health IT solutions and work with them to improve the health care system.
  10. Create a health IT social investment fund. Unlike a traditional venture capital fund whose principal focus is financial return, a health IT social investment fund would measure its success by how effectively its investments help to improve health and health care.

California has a global reputation for technology invention and innovation. Now is the time to apply that creativity to improve the health care for all Californians.