America moves incrementally toward evidence-based medicine, there is growing awareness of the importance of innovation in information management. Mandates for change include improved use of resources, accelerated diffusion of knowledge, and an advanced consumer role.[1] As an initial step, the Health and Human Services’ Office of National

Health Information Infrastructure (NHII) was established to:
  • Advance the development, adoption and implementation of healthcare information technology standards nationally,
  • Ensure that key technical, scientific, economic and other issues affecting the public and private adoption of health information technology are addressed, and
  • Evaluate evidence on the benefits and costs of interoperable health information technology and assess to whom these benefits and costs accrue

This initiative also addresses an expanded view of the traditional functions of information, focusing on seven critical needs:
  • Avoidance of medical errors
  • Improved use of resources
  • Accelerated diffusion of knowledge
  • Reduced variability in access to care
  • Advanced consumer role
  • Strengthened privacy and data protection
  • Promotion of public health and preparedness.

This paper has shown how the current American healthcare system is gravely ill and offers the Wellness-Plus Solution™ as the cure. The Wellness-Plus Solution delivers benefits to all stakeholders through increased quality (safety, effectiveness, efficiency, affordability, timeliness, and availability) coming from advances in health information technology (HIT), along with changes in the way healthcare is delivered and paid

When is comes to HIT, the Wellness-Plus Solution makes detailed patient (and victim) information and decision support available anywhere, any place and any time it is needed to help first responders; healthcare practitioners in hospitals, clinics, and practices; payers; and purchasers interested in the wellness of the community. Through an innovative software system, it provides personalized plans-of-care (PoCs) on-demand to promote wellness throughout the patient’s lifetime and brings the consumer directly into the decision-making process.

One initial approach to implementing the Wellness-Plus Solution is through RHIOs, which are mandated to serve as a responsible cost control agent in their community and to provide healthcare to every citizen. Providers are helped to render high quality care and prevention services by exchanging clinical data with other providers in the RHIO, thereby benefiting their patients, as well as purchasers who have healthier employees. Payers supporting RHIOs financially benefit when patient outcomes improve, since healthier enrollees reduce payer expenditures. And our society benefits from RHIOs since all consumers throughout their lifetimes receive continually improving care and participate in a shared-risk pool that sets premiums at a level in which everyone in the community has access to quality care and preventative services at more affordable prices.

This community wellness paradigm is similar in ways to the automobile insurance industry. Everyone who drives is in the shared-risk pool and has a stake in having good drivers on the road. Government mandates good driving habits through laws, testing, training and regulation.

The Wellness-Plus Solution promotes this approach, and assures all stakeholders receive the information and incentives they need to make knowledgeable decisions and take sensible actions that promote health and well-being. While government would enforce certain enabling policies, the regional community of commercial payers and providers controls the process of healthcare delivery and payment, not the government. Even programs such as Medicare and Medicaid would become commercial entities, thereby removing the government from the healthcare insurance business.

The commercial value of the Wellness-Plus Solution is about $1.8 trillion dollars per year[2], i.e., about $500 per month for each of our county’s 300 million consumers, with government tax incentive given to those with low incomes.
To promote continuous improvement in healthcare effectiveness, safety, and efficiency, the Wellness-Plus Solution focuses on accelerating implementation of evidence based practice guidelines and deployment of advanced information technologies by increasing spending on research and development through tax dollars, philanthropies, and private and corporate investments. This will improve outcomes and lower overall expenditures by reducing medical errors, quality and cost variations, administrative inefficiencies, and uncoordinated care.

On the following pages, we present the “Yellow Brick Road” map as a consumer-centric migration path to policies and technologies that:
  • Focus resources on the development, flow, and utilization of health information and knowledge
  • Promote a web-based platform that creates a comprehensive Electronic Health Record (EHR) and provides management tools to enhance the quality of care and reduce costs
  • Addresses the need for a HIT care management process that provides secure, timely, and up-to-date access to comprehensive patient data and decision support information wherever they reside.

Next: Yellow Brick Road Map

Footnotes and References

[1] International Journal of Electronic Healthcare, Volume 1, no. 4, 2005, Toward a patient – centric medical information model: issues and challenges for US adoption
[2] This figure is based on a new report by economists at the Centers for Medicare and Medicaid Services (CMS), which states that U.S. healthcare spending in 2002 increased for the sixth straight year in a row, hitting $1.6 trillion. This cost translates into an average expenditure of $5,440 per person, up $419 from $5,021 in 2001. We increased the number to $1.6 trillion to account for biosurveillance expense. See

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