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July 06, 2006

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Steve Beller, PhD

Good summary of the current state of affairs!

Following are comments on two quotes:

1. "Many small companies have the expertise but not the financial resources to sponsor large-scale studies."

This is true. I suggest that the small innovative, agile companies -- which can provide next-generation HIT at low cost -- form consortiums that merge the core competencies of each into developing applications addressing the needs of the healthcare community. In addition, having networks of practitioners and researchers collaborate with them to develop and test HIT tools in everyday practice, and to collect comprehensive clinical (encounter) data researchers study and experts use to publish evolving evidenced-based guidelines, would go a long way in dealing with this situation. These are things we are currently doing.

2. "You're not going to get people to make investments in preventing disease, when they are going to make money treating it."

Prevention and other "well-care" services are essential to transforming American healthcare. "Sick-care" providers can participate in well-care, but insurers will have to pay for it, which means convincing them that wellness would likely save payers money in the longer term by preventing or delaying complications to chronic illnesses, by speeding recovery, preventing recurrences, as well as by keeping people healthier longer. Doing this requires a shift of focus (paradigm shift), which is certainly a big challenge.

On the other hand, by training wellness couches/practitioners through innovative programs in innovative universities, there would not be great need for medical professionals to deliver well-care. But again, finding ways to pay for such services is a challenge.

So, in both situations, there needs to be a change in the way money is spent and care is delivered. This shift should focus on funding coalitions of small agile HIT companies and collaborative practitioner-researcher networks.

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