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Extended Interview: U.S. Secretary of Health and Human Services Michael Leavitt

U.S. Secretary of Health and Human Services Michael O. Leavitt spoke to Susan Dentzer about Electronic Health Records.

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  • SUSAN DENTZER:

    We're speaking here with Secretary Michael Leavitt of HHS about the subject of electronic health records and personal health records. Mr. Secretary, thank you for joining us.

  • SECRETARY LEAVITT:

    Thank you, Susan.

  • SUSAN DENTZER:

    Others have said that the US health care system, or "non-system," if you will, is extraordinarily behind in information technology, and possibly is the single industry in the United States that is most behind in terms of its need for information technology and its use to date of HIT. In comparison to financial services or airlines or anything else, it's just woefully behind. How would you state the problem?

  • SECRETARY LEAVITT:

    Well, I would add my voice to that chorus. I think health care is a sector of our economy that has not had the advantage of information technology, and as a result, it's a system that is saturated with inefficiency, and it can and must change.

    It's right at the heart, I think, of so many things, not simply by making electronic things that were previously paper, but by allowing us to become far more efficient and not redoing tests, for example. That's a big cost saver, being able to miss medical — or to prevent medical mistakes. That's another substantial cost saver — being able to make certain that people are not taking incompatible drugs.

    But it's also a huge saver to the consumer, not having to fill out the medical clipboard every time you walk into a physician's office; of being able to make appointments, for example, with your doctor electronically like you do an airline; being able to contact your physician by e-mail like we do everyone else in our system; being able to deal with claims and other kinds of things online as opposed to in a telephone line. Those are things that we ought to be able to enjoy.

  • SUSAN DENTZER:

    You obviously have thought a lot about this problem. What insight do you have as to why health care is so woefully behind in its use of information technology?

  • SECRETARY LEVITT:

    I would point to two things. The first is that health care as a sector is highly dispersed. There's no such thing, for example, as a national health care market like there is banking or airlines or anything else. It tends to be a large series of regional health care markets. That's one important thing.

    Second, there are still lots of small practitioners as opposed to having a series of large providers.

    And third is we've got a fundamental mismatch in the way we finance electronic medical records. The people that are required to make the expenditure or the investment, the doctors and the hospitals, are not the ones who always reap the benefit. So they've been somewhat slow to do that.

    There's also been an important lack of standards. If you compare them to railroads, for example, as I often do, if you're going to have a national railroad, all the rail gauges need to line up. We've had many different people who have been developing health care systems that are electronic, but they've been using different standards so the computers couldn't talk to each other.

    That's where we had to start, was making certain that health care electronic medical records systems could talk to each other.

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