"HIPAA is generally good for healthcare. It is requiring us to do things regarding privacy and security that we should have been doing long before now."
This recent statement-made before a group of information technology professionals by a nationally recognized chief information officer about the regulations of the Health Insurance Portability and Accountability Act of 1996-is a sentiment I have heard frequently during the past year or two. CIOs belong to a pragmatic group largely focused on issues of implementation and management. They usually steer clear of the more esoteric healthcare policy debates in which other healthcare executives become embroiled. However, there is a growing belief among many healthcare IT professionals that the relationship between technology and policy is too close and interrelated for them to remain uninvolved.
Many healthcare policy issues have technology and information management aspects. Likewise, the implementation of most healthcare policies involves technology. To successfully achieve the desired results of these policies, the expertise and knowledge of healthcare IT professionals should help frame and lead relevant legislation, policies, practices, regulations and standards.
Several of the issues currently on the minds of IT professionals include:
* The national health information infrastructure. Connecting healthcare providers, public health professionals and the public for the exchange and protection of health information is the basis for this emerging federal healthcare policy issue. Those outside of the healthcare industry may not understand why-in a field so dependent upon information-this does not already exist. Those of us inside the industry know only too well how patient data becomes quarantined not only within an organization but also within smaller units of that system. C. Martin Harris, CIO of the Cleveland Clinic Foundation, presented the Healthcare Information and Management Systems Society's call at a recent HHS summit for a collaborative effort involving government, industry, providers and others to develop shared technologies, promote standardization of patient identifiers and implement pilot projects demonstrating how this can be accomplished. There are certainly broader social issues, such as the protection of personal privacy, that must be addressed. But failure to understand the technology and information management issues before establishing a policy likely will result in failure of the policy itself.
* National preparedness and response. Anthrax, the Sept. 11, 2001, terrorist attacks, Hurricane Andrew and West Nile virus are just a few examples that demonstrate the need to be able to respond effectively and rapidly in a coordinated fashion to medical emergencies. America's ability to respond to public health crises will depend upon the delivery of critical information when and where needed. Enhanced information technologies must be developed and deployed to detect, pre-emptively manage and, when possible, prevent public health crises. HIMSS endorses the creation of a national Healthcare Information Sharing and Analysis Center to serve these ends.
* Bar coding. For nearly two years, various groups of stakeholders, including IT professionals through HIMSS, have discussed with the Food and Drug Administration how to move forward on questions related to medication labeling. Originating from calls for improved quality and patient safety, the question of mandating bar codes on medications at the unit dose level must be examined from multiple perspectives-IT, nursing, packaging, pharmacy, supply chain and others. Too often, policymakers establish a mandate without ensuring that the components are in place for the policy to achieve its intended objectives. IT professionals participating in this debate will help ensure that common technical standards are defined and workflow is evaluated so that usable and retrievable information is possible throughout the healthcare industry.
The need for information sharing remains consistent across these issues. Commonly used data standards and the ability for applications (business and clinical) to send patient information back and forth are critical implementation features related to the policy issues mentioned here. For these issues to achieve their desig-nated objectives, the barriers to electronic data interchange and systems' ability to work together must be removed. To this end, HIMSS believes that healthcare must pledge to achieve the universal adoption of electronic health records. This will be a massive undertaking, so much so that adoption must be added to the list of major healthcare policy issues. Among other considerations, federal support-through demonstration grants, direct funding and reimbursement incentives-likely will be necessary to achieve the true benefits of electronic records within this generation.
In its 2000 report, the Institute of Medicine noted that one of the advantages of technology is enhancing human performance; a human paired with technology should be more powerful than either element on its own. We also must recognize that this enhancement does not occur simply from the presence of technology. Informed professional debate that leads to coherent national healthcare IT policies is critical for healthcare systems and professionals to achieve maximum results. IT professionals are joining the debate in Washington, state capitals and boardrooms to ensure that we advance the best use of information and management systems for the betterment of health.
Stephen Lieber is president and CEO of the Healthcare Information and Management Systems Society, Chicago.