A Solution to Health Disparities: Improved Health IT


WASHINGTON — Improving health information technology could go a long way toward eliminating disparities in health care, Newt Gingrich said at a meeting sponsored by the Alliance of Minority Medical Associations, the National Association for Equal Opportunity in Higher Education, and the Department of Health and Human Services.

"The challenge is not to be futurist but to bring health care up to the world of the last 20 years," said Mr. Gingrich, former speaker of the House of Representatives and founder of the Center for Health Transformation.

He criticized a recently adopted Florida law that requires physicians to print legibly when they write prescriptions. "First, it's a fantasy to think legislation will convince doctors to print legibly. Secondly, it's the wrong direction for change," he said. "Even a clearly printed prescription remains a paper prescription and misses all the opportunities for checking medication errors, checking other medications, and seeing if there are contraindications. In the long run, the future is an electronic prescription with an expert system to make sure you get the right medication."

People will need to think more creatively, he continued. "Imagine that the medical profession went to major cell phone manufacturers and said, 'We want you to develop a camera capability on a cell phone sufficiently vivid that we could do emergency diagnostics by phone.'"

At the same time, the health care industry needs to find better ways to standardize itself and to disperse information about best practices in medicine, Mr. Gingrich continued. "It can take 17 years for a best practice to reach the average doctor," he said. "We want to set a standard and migrate everybody to that standard."

He gave an example of how electronic health records could improve the standard of care. "A friend's father went in for an MRI, and her mother went in with him. They filled out five paper forms before the MRI. The mother happened to go into the doctor's office as they were preparing to do the MRI, and she said, 'You did know he has a pacemaker?' They stopped right there."

But if the patient had had an electronic health record, "that would have been obvious and automatic, and the expert system would check against it," Mr. Gingrich said, noting that his center is trying to develop "a 21st-century intelligent health system which we believe will end health disparities in America in terms of the delivery of services."

However, such a system would not improve disparities based on culture or ethnicity unless certain problems are addressed, he continued. For example, "diabetes is largely a cultural issue. How you treat diabetes is a medical issue, but how you avoid diabetes is a cultural issue."

Since obesity plays a part in the development of diabetes, he urged audience members to push their home states to institute mandatory, 1-hour daily physical education in public schools and also to ban unhealthy foods from the schools. States that don't do these things "are not serious about obesity in children," he said.

After electronic health records are in place in hospitals and physicians' offices, the next step should be a "Personal Health Knowledge System," Mr. Gingrich continued. The system would be accessible to patients online and would contain genetic profiles that might tell patients such things as whether they have a particular genetic makeup that puts them in the 10% of people who should not eat too many high-fiber foods because doing so could trigger colon cancer, he said.

"You should actually know your DNA before you go grocery shopping," he said. "Within a decade, we'll have an expert system where you'll be able to punch in your health status and it will print out a grocery list."

In fact, food purchases also can be used as an incentive: "If you want to truly help health disparities among the poor, you may want to give bonus points if you use food stamps for the right foods," Mr. Gingrich said. "That sounds like micromanagement, but we've got to be practical about how to shift behavior patterns when people are used to eating food that kills them."

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