As the U.S. gov­ern­ment strug­gles to decide how to fix the country’s health-​​care sys­tems, Dan Fein­berg, director of Northeastern’s health infor­matics pro­gram, has a unique view of the road ahead.

Health infor­matics experts create ways to inte­grate inno­v­a­tive tech­nology into the day-​​to-​​day care of indi­vidual patients. Regard­less of the health-​​care approach that emerges, such experts will be in high demand.

Here, Fein­berg offers his assess­ment of the reform landscape.

What are some of the rea­sons health-​​care reform mea­sures are being slow to move through Congress?

There is fun­da­mental dis­agree­ment over how much reform is nec­es­sary and how fast it should take effect, as well as dis­agree­ment over how much gov­ern­ment should be involved in the solution.

When we talk about a public health plan, what are the most impor­tant things to focus on?

Uni­versal pri­mary care brings value. Coor­di­nated care brings value. Paying for quality rather than pro­ce­dures encour­ages value. Improving effi­ciency of care brings value.

But cut­ting costs by broadly cut­ting pay­ments does not bring value. Nor does lim­iting care.

When we talk of public plans, people look north or over­seas and talk about uni­versal care and government-​​paid care as if they were the same thing. They should also look at the Vet­erans Admin­is­tra­tion, which is both government-​​paid, uni­versal (within a cer­tain pop­u­la­tion), and integrated.

How will the large invest­ment in elec­tronic med­ical records (EMR), which is part of the stim­ulus bill, help health care?

An EMR is a tool. Most of the real value will come from how we use the tool. If we can inte­grate delivery sys­tems, coor­di­nate care, and improve dis­ease man­age­ment using tools like this, then we will see real value and real savings.

For example, an EMR serves as a base for dis­ease man­age­ment sys­tems, which keep dis­ease in con­trol before an expen­sive hos­pital visit is needed. This is an impor­tant part of what stu­dents learn in the health infor­matics pro­gram at North­eastern: the imple­men­ta­tion of the tech­nology, not just the tech­nology itself.

Why are many well-​​regarded groups, like the Amer­ican Med­ical Asso­ci­a­tion, rejecting a pro­posed public health-​​care option?

Gov­ern­ment, espe­cially via Medicare and Med­icaid, has his­tor­i­cally tried to con­trol costs by broadly cut­ting pay­ments. New rules inspired by cer­tain abuses were often so broad that even good uti­liza­tion was finan­cially penal­ized. This leaves doc­tors very wary of gov­ern­ment involvement.

Pres­i­dent Obama has faced crit­i­cism because his plan might give indi­vid­uals with severe med­ical prob­lems little to no cov­erage. How might these patients be better served?

We need to face the fact that a large number of people need a small bit of care and a small number of people need a large amount of care. That is how insur­ance works. But that makes people hear “socialism” and reject such coverage.

Better measurements—partly from elec­tronic records—will con­front us with the truth of what we spend, and this might create a polit­ical opening.

What do you pre­dict will ulti­mately come of Obama’s health-​​care reform and push for uni­versal health care?

With luck, the whole country will look like Mass­a­chu­setts. As a state, we lead the nation in pay­ment reform. We lead the nation in adop­tion of med­ical records and building coordinated-​​care sys­tems around them. The major health-​​care providers in this area are a model of improving pre­ven­ta­tive care and dis­ease management.