Foreword

The U.S. healthcare system has entered the second decade of a sweeping revolution in how information is collected, stored, shared, reasoned with, and used to guide diagnosis and therapy. Digital medicine is now commonplace in hospitals, physicians’ offices, and many other sites of care. It is unheard of to treat patients without using an electronic health record today.

Despite billions of dollars spent and rapid technology adoption, the digital transformation of healthcare has a long journey ahead to realize value for our nation. Foremost among the goals is to apply the vast amounts of electronic data that is now being collected in ways that demonstrably improve patient care. Too often, digital data is locked away, no more accessible or usable than the reams of paper it replaced. Growing volumes of data generated from or by patients isn’t collected or monitored by clinicians in a predictable manner. In most settings, digital data doesn’t follow the patient throughout care, isn’t compiled and analyzed so key trends can be highlighted, and rarely is used in public health and scientific research. Communications among clinicians and between clinicians and patients have not leapt into the digital realm in most instances. In short, patient care is like it has been for decades—yes, electronic, but not transformed.

In some institutions, chief among them Cleveland Clinic, the power of digital medicine is being intensively pursued, and it is changing care delivery. I visited Cleveland Clinic with President George W. Bush at the outset of the nation’s health information technology effort. What has happened since has been dramatic. Minute-by-minute care of inpatients with highly complex conditions is orchestrated by digital communications. Patients in outpatient settings across the world can access top specialists as if they were next door. Health status is monitored so caregivers often know about problems before patients do. Smartphones are harnessed as tools for making care more convenient and higher in quality. Institutions such as Cleveland Clinic are the beacons that demonstrate to the nation—and to the entire world—why the digital revolution is important and how it can bring about the goals we all have for healthcare: greater longevity, less discomfort, better value, and fewer hassles.

This book distills the lessons learned at Cleveland Clinic over the past 25 years into a single and useful reference. C. Martin Harris, MD, whom I met in residency and fellowship 30 years ago, was among the first physician information technology leaders. While I followed the entrepreneurial route, Dr. Harris joined Cleveland Clinic as its chief information officer and pioneered what has now become a required senior executive position in every healthcare system. In his role, Dr. Harris has been at the forefront of the major leaps in health information: quality measurement, teleradiology, consumer engagement, provider communications, workflow management, point-of-care electronic records, telemedicine, and many others. He has been a steadfast and relentless agent of change and has all but written the book—which now he has—on how information drives clinical, technical, and financial success. Martin Harris has few peers with his depth of experience, perseverance, respect, and results.

We are in the early days of digital medicine. As the current wave of electronic record adoption ebbs, the next frontiers of health information are coming into view. Large-scale data analysis, remote care delivery, real-time physiologic monitoring, personalized treatments, and robotics are some of the ways that the last decade of investment will have a meaningful and durable impact on human life. We should continue to watch and learn from Martin Harris and Cleveland Clinic as they lead the way to this promising future of healthcare.

—DAVID BRAILER, MD, PHD

CEO, Health Evolution Partners

National Health Information Technology Coordinator

U.S. Health and Human Services Department (2004–2007)