WellPoint CEO Says Information Technology is Key to Improving Health Care.

WASHINGTON -- One out of 10 Americans is likely to receive medical care that is both not recommended for their condition and potentially harmful, a top health care executive declared today. Citing a groundbreaking study by the RAND Corporation, Leonard D. Schaeffer, chairman and CEO of WellPoint Health Networks Inc. (NYSE:WLP), said the study also showed that 45 percent of patients "do not receive care in accordance with best practices."

Speaking before the "Health IT Summit" here, Schaeffer called for a greater commitment to information technology as a key step towards improving the quality -- and cost -- of health care in the United States. Schaeffer made similar comments in his keynote address at the Sixth Annual David A. Winston Health Policy Lecture on Wednesday (Oct. 20) at the National Press Club.

"Health care information lags 20 years behind other economic sectors," Schaeffer said. "But a cultural shift is occurring. Americans are demanding that the health care sector enter the digital age just as every other sector of the economy has done," Schaeffer said.

The rewards of a stronger IT commitment can be measured many ways, he said. "Moving from a paper-based non-system of care to an IT-enabled, knowledge-based system would:

--reduce medical and prescribing errors

--eliminate duplicate testing 

--lower administrative costs and

--empower consumers to make more informed decisions about their health and health care."

Schaeffer cited a variety of reasons to explain the slow acceptance of information technology, including the current patchwork of enacted or proposed legislation coupled with the rise of multiple groups focused on standards-setting. And, he noted, many stakeholders worry about a repeat of previous bureaucratic structures where rules were complex and the transition was very costly. Finally, among some physicians, there is a perception that the savings from IT flow to payers or patients not the physicians purchasing the system.

"Some of these perceptions will change over time, but reluctance to re-engineer office processes may be harder to overcome," Schaeffer said. "Cost is a big obstacle, but not insurmountable. Government grants and payer programs to reward providers for using IT and large-scale initiatives will help quicken the pace of IT adoption."

According to Schaeffer, health plans like WellPoint are adopting an "infomediary model" that promotes information technology and information transparency. This model puts these plans in a position to analyze large amounts of data to identify what is effective care and who is providing it. With this knowledge, better informed consumers will make decisions based on provider cost and outcomes. Consumers will partner with doctors to decide among treatment options based on their values and preferences.

Further, informed providers will have the information to compare themselves to their peers and improve their use of recommended care. Infomediary health plans will use information to design evidence-based benefits and payment methods to boost the use of evidence-based care.

Schaeffer cited "e-prescribing" as one example of the application of information technology to improve quality and safety in patient care. However, he said the Center for Studying Health System Change recently released a survey of physician IT use and found that only 11 percent of all physician offices use e-prescribing.

To help accelerate information technology applications in health care, WellPoint is giving free technology valued at more than $40 million to more than 20,000 physicians in its networks, either to reduce paperwork or to facilitate e-prescribing.

Concluding that there is no "silver bullet" to reduce costs or improve quality, Schaeffer said three key steps include creating more involved health care consumers, moving health care into the digital age, and making evidence-based care the standard so that purchasers are paying for what works.

"There is no doubt that we will need public and private collaboration and partnerships to achieve these goals more quickly," he said. "While keeping health care accessible and affordable is achievable, it is not inevitable ... we all must demonstrate leadership and we must stay involved."

WellPoint Health Networks Inc. serves the health care needs of 15.5 million medical members and 46.2 million specialty members nationwide through Blue Cross of California, Blue Cross Blue Shield of Georgia, Blue Cross Blue Shield of Missouri, Blue Cross Blue Shield of Wisconsin, HealthLink and UniCare. Visit WellPoint on the web at www.wellpoint.com. Blue Cross of California, Blue Cross Blue Shield of Georgia, Blue Cross Blue Shield of Missouri and Blue Cross Blue Shield of Wisconsin are independent licensees of the Blue Cross and Blue Shield Association.