DANVILLE, Pa. — In the middle of rural Pennsylvania's rolling pastures and farmland sits the sprawling 2 million-square-foot headquarters of what's supposed to be the future of health care.
The Geisinger Health System employs 13,000 people and provides health care to 2.6 million in 42 counties across central and northeastern Pennsylvania. Helicopters fly in and out every day, carrying patients from around the state. Just one of its buildings spans more than five football fields.
The government has chosen this health care metropolis as one of 15 model health care information-technology systems around the country, giving it $16 million in taxpayers' stimulus money to expand its efforts in the hope of dragging much of the country's paper-based health records system and organization into the 21st century.
By modernizing care and generating savings, America's health care costs could drop by as much as $77.8 billion a year, according to a recent report from the Center for Information Technology Leadership, an academic research organization.
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According to the Department of Health and Human Services, $25.8 billion in recovery act money will go toward health information-technology efforts.
Of that, HHS will dole out $2 billion for systems such as Geisinger's, which are aimed at reducing the number of hospitalizations caused by common illnesses such as pulmonary disease and congestive heart failure. In addition to improving health care, the money will create jobs, officials say.
The Obama administration often avoids defining the stimulus as being mainly about jobs.
Vice President Joe Biden, in announcing stimulus grants to Geisinger and the 14 other health care operations around the country, stressed that the money would help improve care by digitizing records. Yet the program's announcement claimed that it would create 1,100 jobs "upfront" and eventually "tens of thousands."
Geisinger will be hiring about 40 people, 10 of whom will focus on IT, according to Dr. James Walker, Geisinger's chief health information officer. Yet the program is more about process and care than jobs or technology.
Most of the money will go to hire about 20 case managers, who'll use the data to track 125 to 150 patients each. By using health care IT systems to track patient care, case managers essentially can pay for themselves by cutting the number of hospitalizations per patient, according to Walker.
Rafael Garcia, a health care IT analyst with Morningstar, an independent research firm, said the improvement in health care IT also could save money by reducing adverse drug events. Overdoses or misuse of prescription drugs kills or injures hundreds of thousands of people a year and costs nearly $6 million per hospital, according to HHS' Agency for Healthcare Research and Quality.
Garcia said health care lagged behind other industries in IT, in part because of the nature of the work.
"It's pretty much the only industry in the U.S. that's still paper-based," he said. "Physicians tend to be busy professionals and don't have time to learn another system."
While electronic systems aren't perfect and can be problematic, going digital isn't really a choice anymore.
While the health care bill that was signed into law in March provides incentives to modernize and stipulates the use of stimulus money to provide grants such as the one to Geisinger, by 2015 it will start penalizing organizations that haven't equipped their data management systems with the latest in technology and know-how.
Walker emphasized health care methodology mixed with technology, however, instead of just expensive equipment.
"The way too much IT operates is they do a big, flashy, expensive thing, and in two years it doesn't exist anymore," he said.
That's why most of Geisinger's stimulus grant will go toward personnel.
Caseworkers and additional staff then will put Geisinger's state-of-the-art information exchange system to work. The digital network has 10,000 authorized users so far, but fewer than 300 of them per month access the system. Geisinger's IT program director, Jim Younkin, said that many more would start using it as more information was included and more people were trained.
Geisinger plans on sustaining the stimulus-created jobs without grants after the third year by selling its information network services to more offices and hospitals in the region that aren't already in its system.
(Frumes is a graduate student at Northwestern University's Medill School of Journalism.)
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