SALT LAKE CITY — The head of Intermountain Healthcare has a simple message as he joins a keynote panel at the World Health Care Congress in Washington, D.C. Monday evening: Doing the right thing in medicine costs less and yields better results.
Dr. Charles W. Sorenson, president and chief executive officer of Intermountain and a still-practicing urologic surgeon, has been tapped to talk about how innovation and market forces can lead to cost-effective care.
Intermountain has become expert at using tools like decision-making prompts, digitized images that are readily available as providers see patients and "best practice" guidelines to eliminate waste, reduce both complications and cost and promote healing. The Utah-Idaho healthcare system gets so many requests for information on its tech-savvy approach that it hosted nearly 200 leaders from other systems around the country last week for a two-day conference on the topic.
Doing more, better, with less is a timely discussion, because healthcare reform and how to do it right have the industry buzzing with questions and suggestions. There's talk of being "accountable care organizations," but "no one's ever seen one," Sorenson told the Deseret News. The question is how to work together as physicians, hospitals, payers — either government or insurers — to make an efficient, cost-effective and healing healthcare environment.
Intermountain's been looking at those issues for a long time and creating different tools. Back in the 1970s, Dr. Homer Warner was using computers not only to store information but to assist in making decisions. Intermountain numbers among its on-staff experts leaders in innovation, data mining and more. Dr. Brent James, for example, is world-renowned as a leader in evidence-based medicine, Sorenson said.
Evidence-based medicine is best-practice medicine and Intermountain has gone so far as to create prompts to help clinicians and care staff remember what's needed for specific conditions. With asthma, for instance, use of a controller drug, whether the patient is symptomatic or not, leads to fewer attacks and complications. But it is harder to remember to stay on it when you have no symptoms, he acknowledged. That's when automation can help because if a prescription isn't being filled, it's not being used.
The field of medicine is full of best-practice examples, from antibiotics before certain surgeries to what drugs should be prescribed to a heart attack patient.
"Doing the right thing costs less. That's my message for the world congress," he said, adding health care focus belongs on what works. "Evidence-based systems with measureable outcomes work. Sometimes we need to face the fact that something is not as good as we thought."
It's medicine by the books that works and Sorenson is proud of what the organization has achieved. It takes rigorous assessment and accuracy, he said.
Electronic medical records make information available as needed to clinicians. If you can look and see not only that an x-ray was done recently but what it showed, for example, you're not going to order new ones. That avoids the time and money costs of duplication.
He also believes that patients, fully informed of their options, will make good choices. "They tend to choose things that they will be more happy with" and not necessarily just the most expensive options."
Incentives matter, as well, he said. When insurance covers 100 percent of the more reasonable treatment — and he means reasonable in both cost and effectiveness terms — but the patient pays a bigger portion of other options, it helps drive good decisions. It's also important, he noted, not to pay doctors more for options that are not the best choice.
Observation and anecdotal evidence don't necessarily tell the true story, Sorenson said. When healthcare systems track clinical outcomes and the cost of caring for patients using objective tools, a true picture emerges.