Friday, March 31, 2006

Welcome and Introduction

Hello and welcome to my blog -- "Curing Healthcare." Following is some background information about my company and me, which I offer as means of introduction.

Professionally, I’m a clinical psychologist, healthcare practitioner, researcher, and software inventor who serves as the President/CEO of National Health Data Systems, Inc. (NHDS), a privately held company founded in 1994.

In 1981, while a practicing psychologist, I began developing a healthcare information system to help me deliver the best possible care by better understanding my patients' problems, determine the best courses of action, evaluate outcomes (the results/consequences of such actions), and continually learn from experience.

By the mid 1980’s, I had developed the key components of the Psychological Services Index™ (PSI) System and began using it in my practice. I soon realized there was more I wanted to know. Not only did I want a way to learn about my patients’/clients’ mental health problems, but I also wanted to a way to know about any related physiological (bodily, medical, somatic) factors that were affecting them. To accomplish this, a team of colleagues and I set out to create the first information technology providing a comprehensive, in-depth, “biopsychosocial” view of patients’ conditions and treatments. This led to a 15-year journey of intensive, cross-discipline R&D (research and development). In the late 1990’s, we succeeded in developing a universal lifetime computerized patient record system with advanced decision support capabilities and a virtual forum supporting interdisciplinary collaboration. We named this software technology the Health Information Index™ (Hii™) System.

In the early 1990’s, as our country attempted to deal with the healthcare crisis of the 20th century, I realized that the efforts being proposed — managed care and capitation — would have to fail because these fiscal strategies didn’t focus on improving care effectiveness and safety. Neither did these strategies promote continuous quality improvement through the implementation of evidence-based practice guidelines, nor the use of information technology for knowledge-building and decision support. And they were fraught with dangers in which those who need healthcare most are the least likely to get it due to things like “cherry-picking,” in which insurers recruit the healthiest clients and avoid chronic patients with expensive health care needs and when providers focus on offering only the most profitable healthcare services while selectively choosing not to provide services that involve more risk, more medical attention or time, more expense those services that do not have a handsome return on investment; a problem that continues today. Another serious problem is that these strategies squeeze providers by paying them to treat as many patients as possible for lowest cost, without adequate focus on the quality of care delivered. We now see the results of such failed strategies in our current 21st century healthcare crisis.

In 1993, I attempted to reach our country’s leaders with a healthcare reform proposal centered on a “national health data system” and creation of an “electronic health information network” which, by the way, is eerily similar our government’s recent call for a “national health information network” (NHIN). The proposal laid out a strategic blueprint for a system supporting collaborative teams of practitioners and researchers across the country using advanced information technologies to build a storehouse of scientific healthcare data. These data would be analyzed, discussed, and transformed into evidence-based practice guidelines, which would be disseminated to all providers. The technology I’d been developing was a step toward realizing this vision. I received no response from the government, however. A year later, we founded our company and named it National Health Data Systems (NHDS).

At the same time, we had begun introducing the PSI System to the mental healthcare field in an attempt to recruit a large group of healthcare professionals to form a collaborative practitioner-researcher network. Our mission was to have this network help evaluate and evolve the technology, and to use it for building a large biopsychosocial knowledgebase. A key strategy of the network was to take a proactive approach with managed care companies by obtaining and using a wealth of scientific evidence and decision tools to support and justify clinical interventions. Unfortunately, the mental healthcare field was generally opposed to this approach and our attempts to establish the network failed. We then shifted our focus away from mental healthcare, per se, to opportunities in other healthcare fields, and beyond.

In 1997, I used the knowledge gained over the years to write a patent for the CP Split™ technology, which was granted a year later. The patent describes a uniquely flexible and efficient process for exchanging and presenting information, which is an ideal platform for supporting healthcare decision-making and knowledge-building in collaborative environments.

In 1998, we developed the Joint Commission on Accreditation of Healthcare Organizations’ IMSystem, which evaluates hospital performance, and NHDS became an approved vendor. That same year, we developed a clinical pathways system for Merck UK, in alliance with UK physicians, which helps diagnose and treat certain heart problems, as well as determine which interventions are most cost-effective. We later developed computerized practice guidelines, case management, and treatment planner tools — all of which also focus on quality improvement. Because of these developments, we were able to integrate the PSI system with biomedical applications, to generate the Hii System, with its universal life-time, electronic health record with built-in decision support.

Sadly, I came up against great resistance from the American healthcare system for the past two decades as I presented our ideas and technologies. Although supported by a small network of healthcare visionaries, we were generally scorned or simply ignored by the healthcare industry — not because of poor technology or faulty ideas, but because the American healthcare system simply wasn’t ready for this type of change. So, while we continued to develop innovative solutions, we were rendered powerless as our healthcare system continued to deteriorate and our company struggled to survive. Why didn’t I give up long ago? Many said I should … it was a losing battle … the system would never change!

What kept me motivated during all these years of disappointment and frustration is a personal life mission to do whatever I can to help improve the world’s health and well-being by enabling delivery of affordable, high-quality healthcare to all people in all nations. If our country focuses sincerely on the same mission, I believe many of the problems we face at home and abroad would begin to repair themselves, and we wouldn’t have to be ashamed of the world we’re leaving our children.

Thankfully, a window of opportunity, for which I’ve been waiting a quarter century, has opened in the spring of 2005 with our government’s initiative to build a national health information network and other strategies to improve healthcare quality and control expenditures. We are responding to this opportunity by presenting a solution evolving over the past 15 years — focusing on a wellness model and quality through knowledge strategy that benefits all healthcare stakeholders — which is aligned with our mission to help improve the world’s health and well-being.

I welcome your comments on this blog, and invite you to post any suggestions, critiques, and questions.

To your health,
Steve Beller


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