You've said there's a need to introduce IT "right into the heart of the practice of medicine." What does that ideally look like? Think about all the participants in the healthcare system. That begins with the patient but includes all the care providers -- doctors, nurses, allied health professionals. It also includes the administrative aspect of healthcare, such as schedulers, registrars, insurance providers. And when I say "into the heart of medicine," what I'm imagining is that there's a time when anyone involved in that cycle will have access to the information they need to make the right decision about that patient as part of the patient-care process or something that facilitates that care process, such as getting a bill paid.
How close is the Cleveland Clinic to that ideal? In the direct patient-care portion, we're pretty far down the road. All of our physicians use the electronic medical record when caring for patients. We have over 500,000 patients who use a patient portal that we call MyChart to access the exact same information as their physicians. It's been framed differently to be more consumer-friendly, but they're looking at the same results their physicians look at. All our registrars use a system that's part of that electronic medical record, and we use an insurance management system that's part of that system.