U.S. CTO: Health care needs better billing systems

>> But let's take healthcare, it's obviously in the news.

>> Yes, sir.

>> And, you know, we all have this dream and this sense that somehow high-tech ought to be able to reduce the cost.

>> And improve quality.

>> Yeah, and after all, I mean, we out here in Silicon Valley live in a world--Reid Hoffman once said this to me very eloquently when we were talking with a senator, you know, we live in a world where we expect the products we use to cost less next year than they cost this year. I mean, we live in the world of Moore's Law. And the senator we were talking with said, what's Moore's Law? And it was, you know, it was a defining moment, you know, because of course the expectation of Washington is that everything will cost more the next year. And so here we have this huge controversy about healthcare reform. And it is, effectively, the story is it's going to cost more. Yesterday, Jeff Immelt said electronic medical records aren't going to reduce cost, in his opinion. He thinks that what we really have to do is figure out how to get better feedback loops around best practices so they become everyday practices. How can we do that?

>> Well, you are opening up a topic that has occupied my mind for a decade. And I would say that there are at least three areas where we have to make progress. First and foremost, Immelt was right in the comment that says, we need to have more market intelligence about what works in healthcare.

>> Yep.

>> If you think about the retailing sector, we have almost perfect market intelligence about point-of-sale transactions across Wal-Mart. So they have sophisticated algorithms to say exactly what they should be doing to optimize sales, given customer behavior. Anybody here want to guess what share of the nation's healthcare data is in a common repository to be mined for analysis, much like the way a Wal-Mart might mine its retailing database?

>> Zero.

>> Thank you for the person who said zero in the audience. It's not that bad, but because we are in a highly fragmented market, the NIH is an example, in cancer, where you would think it would be kind of important for us to have a market of individuals voluntarily sharing their information to learn what works and what doesn't work, can you imagine? Only 3% of the nation's cancer patients are enrolled in a clinical trial that allows them to actually have that clinical trial in cancer to be mined by researchers. 3% on one of the most important topics. So category one, Tim, is finding ways in which we can marry the research and development and the comparative effectiveness work to translate this to policy folks. We have a $1.1 billion package in the economic stimulus that actually creates investments to help us understand what works and what doesn't in healthcare. A good portion of that will be dedicated towards data infrastructure. We haven't released the procurement rules or the rules about how that will be spent, but I can assure you it will have a strong component on data infrastructure with absolute commitment to privacy and voluntary participation in certain aspects. The second question is, how might we achieve--I liked your language about Moore's Law in the actual cost of producing what we do. How might we enable more production innovation into the healthcare space? So we're in the midst of a debate right now about how we set standards and certification rules through regulation for products that wish to help doctors and hospitals achieve, what we're calling in Washington, meaningful use. That is, they can use technology to achieve a broader objective, improve quality, lower costs, improve customer satisfaction. We will issue these rules in December. But we need your voice. On October 29th, the Department of Health and Human Services, through a committee we have set up called the Heath IT Standards Committee, is conducting a one-day workshop on adoption experience. Those of you in the room who understand healthcare information technology, or have experiences in adopting data standards, we need your input. We're going to have a one-day workshop in Washington. We're going to webcast it. But then we're going to have a two-week online forum, a structured dialogue with blog posts and chances for you all to provide feedback. We need your ideas to make sure that the standards we are engaging on can be adopted more quickly and can enable the kind of innovation that you would expect. And that will lead to my third piece. The third piece is some of this stuff is inaudible. We spend 17 pennies on every dollar in healthcare on billing, billing. Literally, I show up in the doctor's office, the doctor may or may not know that I'm an Anthem customer with insurance. They try to verify it, but they may or may not be successful. They send in the bill. The insurance company says no, this person isn't on our insurance. And it goes back and forth and back and forth. 17 cents on every dollar for this? Ludicrous.

==== Transcribed by Automatic Sync Technologies ====