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Leavitt offers ideas to keep costs down

Disease prevention, use of IT systems are among suggestions

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With 77 million baby boomers approaching a time when they will use health-care resources "at maximum levels," U.S. Secretary of Health and Human Services Mike Leavitt says the country has to get a grip on health-care costs.

Sitting in the "Medicare bus" that's already visited 30 states to promote rollout of upcoming pharmacy benefits — his "second office" — Tuesday, he offered thoughts on what must happen to tear down barriers to a more efficient, healthy health system.

Health reform hinges, in large part, on willingness to change the focus, Leavitt said, "moving toward wellness and prevention of disease." That's a trend in progress, with steps like Medicare agreeing to pay for physicals, something it denied for decades, and medications that can improve lives and save money, which will soon be covered under the new Medicare pharmacy benefit.

Another important step to improving overall health care is using information technology in health systems to share information. "The system is saturated with inefficiency," he said. "The use of information technology is underrepresented in this industry."

But the benefits don't stop with saved time when a patient doesn't have to fill out seven separate forms in a doctor's office, the information on them later entered by different workers into different software programs, a huge waste of everyone's time, he added.

"The value is better care at lower cost, fewer medical mistakes and less hassle," Leavitt said.

An IT system where computers communicate — he likened current efforts to early America when all the different railroad companies ran trains on different gauge rails and couldn't travel the same rail lines — would also eliminate the need for patients or couriers to run around gathering test results and scan images to take to the next appointment, cutting lost productivity, the expense of duplicating and other inefficiencies.

One of his challenges as secretary is to oversee efforts to come up with standards for the industry so everyone's computer system can talk to everyone else's, while protecting patient privacy and data security, he said. "That's the foundation of containing costs and improving quality."

An IT system that communicates can alert doctors and pharmacists about medications that interact badly. They can prompt a doctor to start a needed antibiotic or speed the return of lab results. The application of information technology to health care is immense and important, he said.

Such IT linkages would also help national security and public health in case of either bioterrorism or pandemics, Leavitt said. The best sentinels for such events are local emergency rooms, but they must be able to share information electronically.

Americans also need to consider the incentives the entire health system is organized around, he said. Right now those who provide care and patients are separated from those who pay, and that barrier needs to come down, Leavitt said.

He likened it to an invitation at the grocery store to fill your cart at no cost. "It's human nature to buy more than you need if you don't have to pay," he noted. "We've got to get the incentives right."

Finally, Leavitt said he believes that medical liability issues will need to be dealt with as part of health-care reform.

E-mail: lois@desnews.com