The witching hour

Even at the age of 91, I can write an opinion piece for this newspaper in about an hour. Data from respected institutions and researchers show that the following things occur in the U.S. during each hour.

Sixty-eight people die from heart disease, our number-one cause of mortality for more than 75 years.

Sixty-five succumb to cancer, our number two killer during the same decades.

Twenty-seven women are found to have breast cancer, and eighteen of them will get treatments that don't work.

Up to 46 people die because of medical mistakes. Nine people die because their care is not at the level considered best-performing.

During the same hour, $319 million is spent on health care. Of that, $86 million is wasted; $31 million is handed to criminals and fraudsters; and $3.9 million is spent on health information technology.

A recent research finding will make it 0.00067 percent of the way from "bench to bedside." And a dangerous drug will cover 0.0023 percent of its journey to being pulled from the market.

Little of this is new. The data are well-known in the health policy community.

What's new is the promise of information technology to create easy access for doctors and patients to data on what works best.

Reflecting this promise, doctors at Children's Hospital of Philadelphia have created a data-sharing network that will lead to a "learning health system" to replace current anecdotal guesswork among pediatricians and other clinicians.

Today, research shows that just over 10 percent of your doctor's recommendations are based on A-level evidence. The bulk is anecdotal guesswork.

The government has spent more than $30 billion to subsidize the proliferation of information technology.

One visible result is the electronic health record created in the medical office or hospital.

Nowhere is the gap between data and intelligence more evident than in health care. The myriad data systems are neither standardized nor interoperable. Meaningful use of the knowledge is elusive.

So, for example, the lessons learned about what works and doesn't, in 97 percent of adult cancer patients, are lost.

The Department of Health and Human Services has a 10-year strategic vision to address this problem.

After a commitment of more than $30 billion, another decade is inexcusably slow. Those 46 folks dying each hour due to misdiagnosis and errors become four million over 10 years.

The hourly cost in human lives and in dollars of failing to learn, capture, and share what works in medicine is eye-popping. The cost per decade is indefensible.