Surgeon General: Reform, IT Only First Steps to Reduce Health Disparities

U.S. Surgeon General Regina Benjamin offered enthusiastic support Wendesday for efforts to increase adoption for EHRs and other healthcare IT, telling a rapt audience at the HIMSS11 conference in Orlando about her own decision to add a system after all the patient records in her plucky, one-doc practice in Bayou Labatre, Ala., were destroyed in a fire following Hurricane Katrina.

But while healthcare IT, along with efforts via health reform to expand coverage to millions of Americans, are important steps in reducing health disparities and driving public health, they're only the first steps, Benjamin said. "We have to reduce the social determinants of poor health," beginning with poverty, as well as other factors that drive people to make poor health decisions. Benjamin added that America needs a healthcare system whose primary mission is to prevent disease, not just treat it.

Prior to her appointment as surgeon general in 2009, Benjamin was a local family practice physician in Bayou Labatre, a rural shrimping village along the Gulf Coast. Her clinic was destroyed repeatedly by natural disasters, including Katrina. Each time, she and the community rebuilt. In Katrina's aftermath, she and her staff laid their soaked paper patient records out to dry in the hot sun in front of the trailer that was serving as the makeshift town clinic. Showing a photograph of the records lined up in neat rows on the ground, Benjamin said, "HIPAA probably wouldn't like that, and some of them blew away. But we didn’t have a lot of choices."

Yet it wasn't until a subsequent fire in the town's rebuilt clinic, finally destroying every last record, that Benjamin decided that when the clinic was rebuilt again, it would start new, with an electronic records system.

"Before that, I had always thought, 'I just can’t afford an EHR.' I could buy an EHR or I could pay the bills," she recalled. "But when that fire destroyed all of our records, I realized I couldn't afford not to do this."

The HIMSS foundation helped to supply the clinic with hardware, she said.

When an audience member asked her to elaborate on the process of adopting a new records management system in a time of crisis, Benjamin said the total loss of her paper records made it the "perfect time to switch." She acknowledged that "some people are frightened of it," but said, "I knew we needed a better way, a way to evacuate our clinic while safeguarding our records."

Staff got on board quickly, too, she said, something that is unsurprising for a group that had previously been through the experiencing of sun-drying their charts on the front lawn.

"You have to decide, at some point to just make it happen, to just do it. … And yes, there's a learning period, but you also don't have to go looking for charts," she said. "You don't have to figure out who's got the chart. Everybody has the chart."

Bob Keaveney is editorial director of Physicians Practice. He can be reached at bob.keaveney@ubm.com.
Check out the rest of our HIMSS 2011 coverage here.