Bringing Health Care into the 21st Century
By Congressman Randy Forbes, May 30, 2008 -
As a nation, we have been fortunate to be able to provide among the highest quality health care in the world. Our nation’s physicians, our medical schools, and our medical research facilities are demonstrating leadership in health care that is unmatched by global standards. However, we also face many daunting challenges in health care. At the consumer level, health care insurance rates have increased dramatically and many individuals are unable to provide insurance coverage for their families if their workplace does not offer it. At the physician level, skyrocketing medical malpractice insurances rates have forced many physicians to close their practices, limiting the availability of quality physicians to patients.
It is clear that we need significant health care reform, but it is important that we maintain our high standard of quality of care, even as we seek to reduce overall health care costs and increase access to care. I would suggest that one of the most important steps we can take to achieve this goal is to modernize our health care system.
Consider the following: According to a study done by the Institute of Medicine, between 44,000 and 98,000 individuals are killed every year in the United States due to medical errors, and these errors cost the United States upward of $79 billion each year. Nursing shortages are expected to reach 20% by the year 2020 and are forcing some health care facilities to implement mandatory overtime for nurses and increased patient care loads, contributing to an increased number of stress related errors. Medical students are operating under strict rules that limit them to an 80-hour work week leaving less time for direct interactions between students and instructors. If we have the opportunity to significantly decrease the number of medical errors and increase training time – to save lives and to reduce health care costs – wouldn’t we take it?
Modeling and simulation technology uses complex computer models to create artificial environments for hands-on simulated training. As Founder and Chairman of the Congressional Modeling and Simulation Caucus, I have seen these simulation technologies revolutionize fast-paced industries like homeland security and defense that require precise skill work to achieve mission critical results, and it has proven to decrease training costs significantly and improve overall national military readiness. The technology is now making its way to the medical industry.
Most recently, many of our nation’s top teaching hospitals are applying simulation technology to the medical field with impressive results for health care quality and patient safety. Trials have seen the clinical error rate in hospitals drop from 30 percent to almost four percent, which, when applied across the United States, could see medical error costs drop up to $17 billion. Giving physicians the opportunity to practice new or sophisticated techniques will provide considerable cost benefits to patients in the U.S. as well as advance the medical industry as a whole.
Just weeks ago, Dr. Sudhir Srivastava of the University of Chicago successfully performed a minimally-invasive bypass surgery with the spider-like arms of a robot. Technology such as that used by Dr. Srivastava is proving to reduce surgical complications and shorten the amount of time patients must be in the hospital to recover. Unfortunately, it is taking awhile for technology to catch on in the health care industry, primarily due to lack of funding and opportunities for technology training in medical education.
To address this issue, and to emphasize the importance that holistic modernization of health care has on overall health care reform, I have introduced the bipartisan Enhancing SIMULATION (Safety in Medicine, Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now) Act of 2007. This legislation would advance medical simulation by establishing federal grants to purchase medical simulation technology for training, incorporate medical simulation into curricula, and study simulation-based methods in credentialing and accreditation. It also instructs the Department of Health and Human Services to increase the use of simulation technologies and equipment in medical, nursing, and dental education and training protocols through different programs.
Certain types of simulation centers are cost prohibitive for most institutions but there are significant "lessons learned" that can be shared. To coordinate activities and provide leadership, H.R. 4321 would also create a Coordinating Council and several Centers of Excellence. The Coordinating Council would consult with the medical community to coordinate the federal government’s medical simulation investments and programs. Centers of Excellence will advise, train, and assist programs on the use of medical simulation technologies. They will also provide central training facilities and experiences for providers regardless of institutional affiliation.
Today we stand at a critical juncture in health care. We can sit back and wish for a system of empowerment, choice, and quality care that is affordable. Or we can take small, but valuable, steps forward aimed at transforming our health care system. Modernizing health care through the use of technology is an important step in health care reform that will appropriately bring health care in America into the 21st century.