Q and A With Bill Novelli
Healthcare Technology: Can you provide some background on AARP?
Bill Novelli: AARP is a nonprofit, nonpartisan membership organization that helps people over 50 have independence, choice and control in ways that are beneficial and affordable to them and society as a whole. AARP produces AARP The Magazine, published bimonthly, AARP Bulletin, our monthly newspaper, AARP Segunda Juventud, our bimonthly magazine in Spanish and English, NRTA Live & Learn, our quarterly newsletter for 50+ educators and our website, www.aarp.org. AARP Foundation is our affiliated charity that provides security, protection and empowerment to older persons, with support from thousands of volunteers, donors and sponsors.We have staffed offices in all 50 states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands.
HCT: Why are EHRs important for your constituency?
BN: AARPs interest in health information technology stems from our conviction that healthcare quality in the U.S. must be improved. Ultimately we hope that improved care will also lead to cost containment. Americans only receive about 55 percent of recommended care; patients are too often at risk because of avoidable medical mistakes; and scarce resources are wasted through the inappropriate or unnecessary application of technologies or treatments. Health information technology can help play a vital role in addressing these concerns. EHRs can offer clinicians decision support with prompts to conduct tests and treatments based on evidencedbased guidelines, help in monitoring their patients progress and they provide timely reports of laboratory and X-ray results. They also can help reduce error by improving the accuracy and legibility of patient records, help to enhance coordination by facilitating shared use of records and expedite access to medical information and knowledge about medical advancements.
In addition to the potential of improved clinical care, patients benefit from the convenience of online appointments, secure email communications with their clinicians and rapid access to test results. They can also have access to and control of their own medical information,which will empower them to become more engaged in their own care. Ultimately this will contribute to better health outcomes. In particular, EHRs offer people with chronic conditions significant opportunities for self-management of their conditions.
Finally, EHRs can help promote quality improvement by easily and efficiently capturing information that will enable us to use medical-encounter data to measure and benchmark performance, design interventions for improvement, promote public accountability and realign payment methods.
HCT: What is the role of consumer groups in making EHRs happen?
BN: Consumer groups can help stimulate the demand for EHRs by advocating for improved healthcare quality and public accountability of the healthcare system and educating their constituents about the need for improvement, making informed healthcare decisions, accepting appropriate responsibility for their own health and engaging in healthy behaviors. AARP believes that stimulating the demand side will encourage clinicians and healthcare institutions to seek cost-effective and efficient ways of responding and will lead to more rapid adoption of EHRS.
HCT: What are some of the implementation challenges?
BN: There are many formidable challenges to overcoming barriers such as cost; the lack of interoperability; the absence to date of a common nomenclature or standards for data aggregation, storage and communication; provider and practitioner resistance; and more. From a consumer perspective, the major implementation challenges relate to designing consumer-centric care standards that will permit a focus on patient outcomes. In addition, many consumers may be suspicious of the connectivity that comes with EHRs in the healthcare setting. Therefore a standardized health information infrastructure that will ensure the protection and security of patient information is key to address these concerns. Without such assurance, patients will not have confidence in EHRs.
HCT: What is on the horizon for EHRs? Will there be widespread adoption in the next five years?
BN: Of course it is difficult to predict precisely when widespread adoption of EHRs will occur. In my view, five years may be optimistic. However, we do know that it will take leadership from a wide range of stakeholders who will champion the importance of improved healthcare quality and recognize that health information technology is an essential component to improvement. This means that, in addition to the healthcare community, consumers, public and private purchasers, regulators, accreditors and others must participate in a full-scale effort to achieve the Institute of Medicines six aims of the 21st-century healthcare system: safe, effective, patientcentered, timely, efficient and equitable. It is highly unlikely that these aims can be achieved without applying healthcare technology to healthcare.
