HIMSS14: Bertolini calls upon health IT to cut the waste

ORLANDO--Five percent of patients consume 43 percent of total healthcare costs. To drive down expenditures, the healthcare industry needs to target the most chronically ill patients, who are managed by multiple physicians and often take as many as 25 prescription medications, said Mark T. Bertolini, chairman, CEO and president of Aetna in his keynote speech at the Healthcare Information and Management Systems Society annual meeting.

In addition to providing better care to the chronically ill, Bertolini advocated for increased spending in wellness and aligned incentives around better care to keep people “productive, economically viable and satisfied.”

The industry engages in $800 billion of wasteful spending per year, he said, citing a 2009 study. “This should be the focus of our efforts, our policy decisions, our solutions, our IT—how to get to this waste. Our systems are not functioning right.”

Tackling the epidemic of chronic disease means offering relevant, simple tools for the chronically ill to enable them to better manage their health, he said. “The system needs to change its focus on individuals so the hospitals and health systems can make them better. They need to be connected to technology.”

He cited an initiative where patients at risk of chronic heart failure (CHF) received Bluetooth technology scales and visits from clinicians who handled medication adherence barriers and removed safety hazards, such as rugs, to prevent falls in the home. The effort reduced CHF readmissions by 49 percent, in large part because clinicians were able to catch water weight gain before it manifested into something serious, he said.

To incite positive behavioral change in consumers, healthcare must be simple and convenient. That means, instead of the hassle of setting up a physician visit for a flu shot, and possibly taking off work in the process, consumers can go to the nearest Minute Clinic on the way to work to get it done. Also, they can harness mobile technology using chronic disease management apps or other trackers. “That way you are carrying a healthcare system in your pocket.”

Healthcare costs continue to be staggering, with premiums growing at four times the rate of inflation. “It’s unsustainable. Soon it will consume one-fourth of our income,” Bertolini said.

Employees currently pay 41 percent of their healthcare costs, and if that continues to trend upward, “we’ll reach that point that you’ll have a very different customer in front of you” asking for transparency in healthcare costs and services.

He recalled an incident where he scanned a sweater with his smartphone at a department store, and “within 45 seconds” learned its cost, as well as directions to another store that offered the same sweater at a lower price. He drove to the other store and ended up buying two sweaters: one for his daughter and the other to show his colleagues to relay the experience. “We have to have this for healthcare.”