Health Care Innovator Sees Pain Before ProgressHealth Care Innovator Sees Pain Before Progress

John Glaser, CIO at Partners Healthcare, is a bit of a contrarian among health care IT leaders, though some might just call him a realist.

Either way, Glaser--who in his 20s hitchhiked from Fairbanks, Alaska, to the Panama Canal--isn't afraid to challenge the status quo. After a dozen years as CIO at Partners HealthCare, which operates several Boston-area hospitals, including Massachusetts General and Brigham & Women's, Glaser is skeptical of some high-profile electronic health records efforts. Yet he's also helping Partners take one of the industry's toughest stances on e-records adoption.

When it comes to high-profile efforts by employers, such as Wal-Mart and Intel's Dossia consortium, to rein in costs by giving workers access to digital personal health records, Glaser doesn't expect much in terms of changing health habits or greater e-record use. "IT can mitigate costs but not solve the cost problem," he says. Similarly, Glaser isn't sold on efforts by Google, Microsoft, and Steve Case's Revolution Health to push consumers to use personal health records. "It's very noisy, lots of action," he says. For every 10 patients who have access to a digital health record, he thinks only one on average will look at it, so consumers won't drive e-record adoption.

But Glaser isn't just shooting down ideas for using IT in health care; he's a firm believer that e-records can improve care and cut costs by giving doctors better data and information sharing. He's founding chairman of the College of Healthcare Information Management Executives and co-creator of the New England Health EDI Network, a consortium that lets health care providers swap administrative and payment data with insurers. Still, he isn't convinced such regional health information organizations will evolve into the one national health information highway that many envision. There's no business model, he says. Instead, providers will make data-sharing deals as needed.

Partners, an early adopter of e-records and computerized order entry, now is mandating its doctors agree by January to deploy digital health records or be dropped from the network. Glaser's IT group is providing doctors with technical support for the rollouts, "like a mini vendor," he says.

Glaser thinks it'll be decades before a majority of Americans have e-health records--not 2014, as President Bush set as a goal three years ago. But progress will happen. "There will be different levels of pain, and a form of chaos, before order."

Q&A With John Glaser

information: Besides Partners, do you know of any other large health care provider that's mandating their doctors provide e-medical records?

Glaser: I'm not aware of another organization that has taken the step that Partners has of requiring EMR use by non-employed physicians. There are organizations that employ their physicians, including the VA, Kaiser Permanente, Group Health, that have made EMR use a requirement of employment. But about 2, 000 of our physicians aren't employed. They're affiliated, and I'm not aware of an organization that has said that it will end affiliation if there's no EMR use.

IW: Do you have kids, hobbies, interests outside of the health care and IT?

Glaser: I have three daughters, ages 24, 21, and 18. I play racquetball and write-140 articles and seven books, including a children's book and two books that are compilations of letters to my parents.

IW: Anything else people would be surprised to learn about you?

Glaser: I was more interesting in my youth-expelled from high school, hitchhiked from Fairbanks, Alaska, to the Panama Canal, taught wilderness skills, and went to clown school.

IW: Clown school?

Glaser: I still have my makeup in the attic. I can do a passable juggle.

IW: How long did it take you to hitchhike from Alaska to the Panama Canal?

Glaser: I had a job in a salmon cannery in South Naknek, Alaska, during the summer of 1976. I hit the road in August 1976 and wound up in Panama in January 1977. My route was not that direct. Once I hit Denver I hitched to North Carolina to see my girlfriend-now my wife-and then hitched to LA and then south through Baja and the Pan American highway.

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