Change for the better is under way with Obamacare

Talk about it

The Patient Protection and Affordable Care Act of 2010 (“Obamacare”) is a major step forward in the improvement of health care and community health status in this country. I speak from the perspective of 35 years in health care, first as a pharmacist and later as a hospital administrator and health system executive.

While much has been written about the new law’s impact on expanding coverage, assuring access and controlling costs, there are several other important aspects of the law that will dramatically improve the quality of health care and elevate the health status of the American community at-large. In this regard, I would cite three key features of the new law.

The first is the electronic health record (computerized medical records). The new law builds upon prior legislation (the stimulus bill of 2009) in providing strong incentives for every component of the health-care delivery system to adopt electronic health records as a direct replacement of paper medical records. This shift already is under way on a massive scale across the country.

A second and related feature is the encouragement of “evidence-based” patient care, which is the conscientious and consistent use of well-proven, broadly accepted, cost-effective methods in the care of individual patients to achieve the best short-term and long-term outcomes in the most efficient manner. In short, the new law fosters payment for care that works and will, over time, discourage payment for services that don’t. The system-wide use of electronic health records will provide a rich source of data that will expand the knowledge base of

evidence-based patient care while still assuring strict adherence to patient-confidentiality standards. These aspects of the law will enhance the doctor-patient relationship by providing significantly improved information regarding the most effective treatment options, effectively making patient consent to treatment that much more informed. This should produce a corresponding reduction in risk of malpractice litigation facing health-care providers.

Third, the new law fosters coordinated care, encouraging a patient-centered model of care, wherein all components of the care-delivery system are incentivized to work together in the patient’s best interest. Coordinated care also is advanced by the law’s explicit recognition of the importance of prevention, early diagnosis, prompt intervention and ongoing care management by primary-care physicians, advanced-practice nurses, physician’s assistants and other qualified health-care professionals.

The electronic health record and evidence-based patient care are important elements for achieving optimal coordination of care.

Coordinated, comprehensive, cost-effective, high-quality care is best achieved in organized health-care delivery systems. In such systems, all components of health care are brought together under a single organizational umbrella, the center of which is a patient-centered mission.

Duluth is fortunate to have two excellent examples of such systems: Essentia Health and St. Luke’s. Both have major similarities to the highly regarded Mayo Health System, including a broad array of highly skilled specialists linked with excellent primary-care professionals, all supported by expert health-care teams and state-of-the-art technology and facilities. The new law encourages the formation of such systems and promotes linkages among providers across entire regions, thereby reducing the risk of errors, omissions and duplicated services.

None of these changes is easy, yet each is essential to achieving cost-effective, high-quality care that is available to all.

While Obamacare is not a perfect piece of legislation, it provides an excellent foundation and framework for dealing effectively with the many dysfunctional and disconnected aspects of health care in this country. Additional modifications to the law and related regulations surely will be made in response to patients, health-care providers, employers, insurance companies and religious organizations. These are to be expected in a representative democracy and are best done in the light of day.

The above components, along with the law’s many other features, hold the promise of controlling costs, improving quality, expanding access and improving health status in this country. These are changes many within health care have advocated for years. With Obamacare, change for the better is under way.

Jim Cherveny of Duluth is retired from the former SMDC Health System (now Essentia Health East), where he was executive vice president of the Hospital Division.

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