Advising the Obama Administration
You served as co-chair of a task force that advised the Obama administration on how to transform health care through information technology. What are the key ways health care can be transformed using information technology? What recommendations did you make to the government? The real message was that until we get widespread adoption of electronic health records, all the other things that you're trying to accomplish in health care can't be done.Look at all the things we're trying to do in terms of expanding access and improving quality and lowering costs. The fundamental underpinning is the widespread adoption of electronic health records and the use of health information exchange.Did you play a role in advising the administration on the stimulus plan, HITECH, ARRA? Yes. Much of the recommendations that were in the task force report, many of those wound up being part of-I can't say they were directly part of or listed straight out-but certainly the concepts that were in there, many of those came out in HITECH. So it felt pretty validated there. We at Perot Systems and Dell have been very active with what's been going on with meaningful use. We provided extensive comments in each of the comment periods. One of the things we suggested was the concept of introducing some flexibility into the meaningful use requirements, and we laid out a model, which is actually quite similar to what ultimately came out in the final rule of the core set and menu set of options to allow some flexibility. One of the things we had seen in the market was that many organizations were at different levels of adoption. Some were greenfield, some were pretty far along, and ultimately the destination where the government wants everyone is the same place. But the route people would take to get there, depending on where they are now, would be somewhat different, and we needed to build in some flexibility. What are the pitfalls of transforming health care with technology? The biggest pitfall is really focusing purely on the technology. I always joke: There are plenty of people who can build a better mousetrap, but unless you understand the mice, you're not going to be successful. These are very complex environments. In how information has been handled historically, literally for the last hundred years since people have been keeping medical records in any formalized sense, it's a lot of legacy to overcome. Health care is a very conservative industry. It's an appropriate conservatism in the technology piece alone, but at the same, we have lasers, we have robots, we've got a lot of cool stuff in health care right now. It just takes awhile for the culture to say we're actually going to get some widespread adoption of this. And electronic health records will be the same way. It will take awhile, and people will have to change the way they approach some aspects, but they'll find some real improvement.