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Virginia's
secretaries of technology have made their marks upon
the Commonwealth in very different ways. Don Upson
employed his penchant for PR to gain national
recognition for Northern Virginia's world-class
technology sector. George Newstrom rationalized the
state's IT infrastructure through the creation of
the Virginia Information Technology Agency. Eugene
Huang oversaw the development of super-high
speed connections between the state's research
universities. Aneesh
P. Chopra, Gov. Tim Kaine's secretary of technology,
will bring his unique talents to bear in ways never
envisioned by his predecessors. Gregarious, animated
and an impassioned public speaker, the 33-year-old
Chopra presides over the smallest secretariat in the
Governor's cabinet. But his modest administrative
responsibilities give him more latitude to range
freely, make connections and spark creativity. It's
still early in the administration, and Chopra is
still soaking up knowledge about downstate
Virginia's
variegated tech sectors, so there's no way of
telling where Mr. New-Idea-a-Minute might take off
next. But based on my conversation with him a week
or so ago, I expect him to focus his energies
in two areas:
A
technology secretary delving into healthcare policy?
Absolutely. Kaine has made health care one of the
top priorities of his administration. At the top of
the list: Taming Medicaid costs through the
application of information technology.
Chopra
is well suited for the goals that Kaine has set. He
studied health policy as an undergraduate at the
Johns Hopkins University, did a stint as a financial
analyst for the healthcare industry at Morgan
Stanley, and studied health policy some more at the
Kennedy School of Government at Harvard. He then
took a job with The Advisory Board in Arlington
providing cutting-edge research on best business
practices in the health care sector.
The
Advisory Board was not a classic consulting firm,
Chopra explains. The firm charged a fixed membership
fee in the range of $20,000 to $30,000 a year.
Chopra, who worked with hospital CFOs to identify
the most pressing issues, would pool those resources
and conduct a dozen detailed research studies each
year. "We’d
scour the country for best practices," he says. "We'd identify eight to ten to twelve
ideas that solve the problem. We'd publish studies,
hosting meetings and share the materials."
Chopra
would like to apply that methodology to solving
problems in government -- both in health care and in
the traditional technology portfolio.
As Secretary of Technology,
Chopra serves on the Virginia Research and
Technology Advisory Commission, which advises the governor
on policies that promote the competitiveness of
Virginia's private industry and research
universities. Early in the administration, he convened a meeting of the eight
vice presidents of university research, who also
serve on the board, and asked them, "Tell me
what you do. What are your problem areas? Where are
you frustrated? What can we improve?"
His
hope, says Chopra, is to identify best practices
that all the universities can share. For instance,
it turns out that one university, which he
declines to name, has identified one reason why it's
so hard to transfer technology from the university
lab into the marketplace: Many of its faculty simply
don't realize that their ideas have economic value.
And even if they did, they wouldn't know where to
go. The research v.p. has developed a presentation he takes
to faculty members explaining the value of research
as commercializable property and then shares ideas
on how to locate business partners. It's a program, he suggests, that other
Virginia universities would do well to emulate.
While
Chopra is obviously a quick study for a wide range
of technologies, his passion is health care. He wants to use his four-year
tenure as secretary of technology first to help
raise the administration of Virginia's Medicaid
program to world-class standards of efficiency, and
then to parlay success in that endeavor into
achieving the Governor's goal of reducing the number
of medically uninsured in Virginia by one third.
While
the Governor has been tangling with the General
Assembly over transportation and tax issues in the
early months of his administration, Chopra and
Tavenner have been working quietly behind the scenes
on Medicaid reform. In a program called Direct
Connect, to be formally announced this July, the
Commonwealth will make it possible for six major
health care systems around the state to tap into the
state Medicaid database. Chopra sees the potential
for considerable administrative savings.
First,
Direct Connect will allow hospitals to determine if
a patient qualifies for Medicaid before submitting
the Medicaid paperwork, which in many cases results
in a denial. There's no point in doing
the work if the filing is just going to get
rejected. Similarly, the program will spot patients
who may qualify for Medicaid without knowing it.
That beats trying to squeeze hospital bills out of
people who can't pay them.
If
Direct Connect is successful, Chopra says, he sees
many ways to build upon it. Medicaid patients hop
around a lot between doctors, emergency rooms and
hospitals. For many patients, the state Department
of Medical Assistance Services is the only entity
that maintains a comprehensive database on their
medical history. Chopra anticipates allowing
hospitals and physicians to plug into the Medicaid
database to avoid giving redundant tests, for
instance, or to check what medications a patient might
be taking. Smart use of technology can help Medicaid
improve patient outcomes and save money.
Chopra
also is eager to apply telemedicine to improving the
quality of healthcare in Virginia's small towns and
hamlets. On a trade mission to India with Gov. Mark R. Warner last year, he visited one of the world's largest, most efficient
heart hospitals in Bangalore. This hospital
maintained satellite links to more than 45 hospitals
and clinics throughout Africa, Asia and the Middle
East. By using inexpensive sensors that monitored
the patients' vital signs, one cardiologist could
observe dozens of patients -- a level of productivity
unheard of in the United States.
The
Sentara Health System is moving in a similar
direction,
however, using a central facility to monitor
patients in its seven hospitals scattered around
Hampton Roads. Could Sentara or other health giants,
asks Chopra, extend the service to small,
rural hospitals in Virginia that have difficulty
recruiting physicians?
In
the Chopra schema, reducing the cost of medical
treatments and associated, insurance-related paper
shuffling will result in lower charges, making
health care insurance more affordable for everyone
-- including the uninsured.
There may
be other reasons, Chopra acknowledges, why the
number of people lacking medical insurance is so
high. One of them, I noted during my conversation
with him, was the extraordinarily high number of
mandated benefits in Virginia that makes it impossible for small
businesses to provide basic, stripped-down coverage for employees. Chopra didn't dispute my
observation but said he's not interested in making
structural reforms to the healthcare sector that has
winners and losers. He wants to focus on technology
applications that shave costs, improve the quality
of medical care and create winners all around.
"If
I can earn credibility on the cost savings and
quality front," he says, "We can engender
good will on the more difficult challenge of
tackling the uninsured problem."
--
April 17, 2006
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