Page 30 - Delaware Medical Journal - May/June 2018
P. 30
Technology and Health
Care Transformation
Janice L. Lee, MD
I mid-1980s, fresh out of my residency, and assigned to a family practice clinic in Okinawa, Japan. In the way of the military,
within a year, I was Chief of Family Practice and overwhelmed by the number and variety of reports I was expected to produce. I had no clerical support, so each report was composed and typed by me.
and I quickly saw that I could use such a tool to save time and be more productive by creating a template that could be easily updated for recurring reports. This was my introduction to information technology in health care, and my yardstick for technology adoption ever since has been, “Will this help me do something I care about faster, with less effort, more accurately, or at lower cost? Will this help me do things I care about that were previously out of my reach?” Only if I can answer “yes” is it worth the expense and the learning curve. Technology is an enabler, not an end in itself.
In February of 2013, the Center for Medicare & Medicaid Innovation (CMMI), under the State Innovation Models (SIM) initiative, awarded Delaware a “design” grant, which funded the development of the State Health Innovation Plan (SHIP).1 The goal of the initiative is to support states in the development and testing of multi-payer, value-based payment and delivery system reform models in order to achieve the “Triple Aim” of better health for populations, better quality of care, and lower costs.2
The Delaware SHIP was developed through a remarkable public-private collaboration involving scores of hours of public meetings and stakeholder input. Delaware added a “plus one” to the Triple Aim — the goal of restoring joy to the practice of medicine. In December of 2014, Delaware was awarded a $35 million grant to test our model.
Among the core elements of the SHIP was recognition of the role of technology in enabling the desired changes.3 It was acknowledged that technology is costly, and small practices could only afford these tools if they were available as shared resources, with costs widely distributed across many users. The vision for shared resources included: 1) expansion of the clinical information in the Delaware Health Information Network (DHIN) Community Health Record to include data from ambulatory providers, nursing homes, and home care
158
Del Med J | May/June 2018 | Vol. 90 | No. 5
