More Data Needed for Consumer-Driven Health Care


WASHINGTON — Consumer-driven health care may be the “next big thing” in health insurance, but it won't go anywhere until more data on plans, providers, and outcomes become available, George Halvorson said at a health care congress sponsored by the Wall Street Journal and CNBC.

A consumer-driven health plan typically involves a high-deductible health policy combined with a health savings account. Patients initially use money from their account to pay for the first few thousand dollars of health care before the catastrophic policy kicks in.

Although the popularity of such plans may be on the rise, Mr. Halvorson, chairman and CEO of Kaiser Foundation Health Plan, Oakland, Calif., cautioned that many major and expensive trends in care “too often lack scientific backing.” He cited the examples of hormone therapy for heart attack prevention in women, knee surgery to relieve osteoporosis pain, and cyclooxygenase-2 (COX-2) inhibitors for arthritis pain, where the therapy turned out not to work as well as expected.

“Because there's no consistent database in health care, people did not realize this kind of outcome was happening with something that was a very popular treatment,” he said.

Mr. Halvorson recommended that health care executives follow the example of other industries. For example, General Electric instituted a program of “measure, analyze, improve, and control” to weed out errors in its manufacturing process.

Health care doesn't do any of those four steps with any great consistency, Mr. Halvorson continued. “Where does health care get the data that are used? We get it from paper medical records, which are not even complete per patient.” For instance, he said, “we have one patient, four doctors—four unrelated, unconnected, noncommunicative, nonintuitive, noninteractive, too often inaccessible, and often illegible, paper medical records from which to derive the database.”

In addition to the well-known data-collection tools such as electronic medical records (EMRs) and computerized physician order-entry systems, the health care system also should be systematically collecting other information, such as whether patients fill their prescriptions, he said.

Another subject about which more data are needed is the hospital shift change. “It takes an average 43 minutes to do a shift change [and exchange information about patients], and during that time, patients are hitting their buzzer and taking their own steps to the restroom and falling,” Mr. Halvorson said. “By automating that process, you can take the shift change from 43 minutes down to 12 [and] improve patient safety.”

Although the U.S. health care system is better than it's ever been, and the technology is better than it has ever been, “we will not be able to realize the full potential of it until we can get an information flow, and the flow has to come from an EMR,” he said.

Next Article: