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"The development of an information technology infrastructure has enormous potential to improve the safety, quality, and efficiency of healthcare in the United States." — Institute of Medicine, 2001

A consumer sitting in Tupelo at his personal computer can better manage his multiple bank accounts than his multiple chronic conditions because he has far better access to financial information than healthcare information. We can do better.

A physician in Hattiesburg can go online and get detailed information about any drug in the market in seconds, yet would have to make numerous inquiries to try to learn what medications his or her own patients are taking. We can do better.

Businesses all over the state have moved online to cut costs and improve service; yet in healthcare, paper is still the predominant form of information exchange with costs and service suffering accordingly. We can do better.

The United States is facing a national healthcare crisis that is in desperate need of a national solution. However, Mississippi should not wait for a national solution to address the cost, quality, and safety of healthcare delivery. Mississippi citizens deserve a high quality, affordable healthcare system that addresses these fundamentals.

The Institute of Medicine's report, To Err is Human, brought to the nation's attention the problems of safety and quality in the delivery of healthcare in 2000. An identified contributor to these problems is the limited application of Health Information Technology to ensure exchange of patient information among healthcare providers. The lack of available, timely health information can contribute to ineffective delivery of care in the form of: healthcare consumers writing down their healthcare information on a paper form for every healthcare provider they see, because it's not readily available in an electronic format that can be shared among providers; providers making treatment decisions based on incomplete information at the point of care, because historical consumer information is not readily available; and emergency care providers having to make treatment decisions based on the scraps of information obtained from patients or family members, because historical consumer information is not immediately accessible during a crisis.

The lack of health information can also result in duplicate tests and procedures; medication errors; improper diagnosis and treatment; compromised quality and safety of healthcare delivery; and adverse outcomes from medical errors.

Every day, consumers receive treatment heavily dependent on a fragmented, paper-based system, where collected health information is stored in individual provider practices making it difficult for both providers and consumers to access timely information. Compounding the problem, consumers have limited access and control over this information. While consumers' privacy rights are protected under current federal Health Insurance Portability and Accountability Act (HIPAA) law, no reliable method exists for consumers to know if their personal information is being accessed or exchanged, and by whom. In addition, healthcare information can currently be exchanged for the purposes of providing treatment, processing payment with third-party payers, and healthcare organizational operations without prior notification to or consent from the consumer.

In 2001, the Institute of Medicine explored this problem and concluded that the development of an information technology infrastructure has enormous potential to improve the safety, quality, and efficiency of healthcare in the United States. To make these improvements, health information must be electronic so it can be mobilized. This requires that providers use electronic medical record systems. Also, a mechanism must be developed to collect consumers' health information, with their consent, from wherever it is created and make it available when needed.

The Electronic Medical Record (EMR) adoption rate for small to mid-sized practices in Mississippi is estimated at approximately 15 to 25 percent. It is important to note this adoption rate reflects the national average. There are some larger systems within Mississippi that have invested in information technology but are not interoperable with other systems around the state. Considering that a large portion of healthcare consumers receive care from smaller practices, it is reasonable to conclude that many consumers would not have access to Health IT. Therefore, these consumers would be unable to derive any benefit from a health information infrastructure without broad adoption of EMRs.

In addition to building health information infrastructure and the need for the adoption of EMRs, the concept of an electronic personal health record as a tool for consumers to access and manage their healthcare information has drawn attention to the need for interoperability. Although patients' access to health information through these tools is not yet widely used, growing evidence of its positive impacts on the quality and cost of care are emerging. Consumers are becoming increasingly involved in health prevention, wellness, and treatment decisions aided by the use of these tools. However, the effectiveness of the personal health record is limited by the lack of system interconnectivity and readily available personal health information from providers.

In response to the need to make health information available to consumers in Mississippi, Gov. Barbour issued an executive order on March 7 for a task force to be established in order to develop and recommend a strategy for a statewide health information infrastructure. This infrastructure would promote the interoperability of health information systems, and the adoption of EMRs. The first mandate of this task force is to develop and present an action plan, or roadmap, that will be used to accomplish the goals of this executive order.

The Mississippi Health Information Infrastructure Task Force members have met and begun the task of developing the roadmap. They are: Dr. James S. McIlwain, president of Information & Quality Healthcare, chair; Chris Anderson, CEO of Singing River Hospital System, co-chair; Dr. Sidney Bondurant, Mississippi House of Representatives; Mary Helen Bowen, director of pharmacy for St. Dominic Hospital; Terry Burton, Mississippi Senate; Phillip Clendenin, CEO of River Region Health System; Dr. Ken Davis, medical director of North Mississippi Health System; Sam Dawkins, director of health policy and planning for the Mississippi Department of Health; Dr. John Fitzpatrick, president of the medical staff at Hattiesburg Clinic; Ricki Garrett, executive director of the Mississippi Nurses Association; Patsy Hathorn, director of clinical resource management for Mississippi Baptist Medical Center; Steve Holland, Mississippi House; Dr. Warren Jones, professor of health policy for the University of Mississippi Medical Center (UMC); David Litchliter, executive director of the Mississippi Department of Information Technology Services; Alan Nunnelee, Mississippi Senate; Ann Peden, associate professor of health information management for UMC; Teresa Planch, state insurance administrator for the Mississippi Department of Finance and Administration; Bill Rudman, PhD, professor of health sciences at UMC; Scott Stringer, vice president of technology and development for BlueCross BlueShield of Mississippi; and Timothy Thomas, CEO of Newton Regional Hospital.


July 2007

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