Healthcare IT has the Big Mo in Washington. Everybody from President Bush to Hillary Rodham Clinton to Newt Gingrich is vying to be the geek bellwether who points and clicks us to the promised land where all computers talk the same language and we're all on the same home page.
This enthusiasm-manifested in a slew of standard-writing and bill-proposing and the appointment of a coordinator of national health information technology-is good news. Government has a major role to play in helping to prod the industry to work together and faster to achieve that holy grail of a national electronic health record. Thus it was encouraging last month to see Bush channeling John F. Kennedy in setting a 10-year goal for getting rid of all those paper records.
There is a very large dark lining to this silver cloud, however, which everyone can see: It's made up of the hundreds of billions of dollars needed to pay to meet this goal. The fiscal 2005 budget plan contains just $100 million in IT grants and demonstration projects. To put that in perspective, Kaiser Permanente is spending more than $2 billion to create electronic medical records for 6 million patients.
We keep hearing references to a Hill-Burton Act for IT, but even HHS Secretary Tommy Thompson's plan to divert half the funds recovered from fraud-and-abuse settlements to spur information systems has gone nowhere. There simply isn't the money or the will in this fiscal climate to back up the rhetoric.
Every provider knows that investments in IT usually don't pay off in added reimbursements, even if there is a promise of better quality and lower costs some day. The talk in Washington earlier this month of legislation to reduce Medicare payments for providers who stick to paper records only served to add to the doubt surrounding such investments.
The fact is that we seem to cover as many stories about providers such as Cedars-Sinai Medical Center in Los Angeles and Baptist Health System in Birmingham, Ala., abandoning ambitious IT projects as we do about high-tech successes. Even Kaiser wasted millions of dollars before abandoning its homegrown IT solution in favor of a vendor's product.
The answer to the funding conundrum is still hazy, but here is an educated guess: Some day national standards and positive payment incentives will create a template for the design of right-sized and more affordable information systems. Vendors and providers will meet somewhere in the middle between Rolls-Royce systems with unnecessary gadgets and Hyundai systems that don't have standard components such as clinical pathways. The good news is that that day seems closer than it did before.
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We work hard for our readers anyway, but it is nice to be recognized for our efforts. The American Society of Healthcare Publication Editors has named Modern Healthcare its 2004 Publication of the Year. This is the group's most prestigious award, given in recognition of a publication's overall editorial excellence. Modern Healthcare also received seven other awards from the ASHPE:
* Gold Awards: Best Regular Department (Medical Advances); Best News Section (Week in Healthcare); Best Single News Article ("Killer credentials," Dec. 22/29, 2003, p. 6); and Best Overall Web Publication (modernhealthcare.com).
* Silver Awards: Best Special Supplement (By the Numbers); and Best Online News Section (modernhealthcare.com).
* Bronze Award: Best Signed Editorial ("Bad medicine," June 23, 2003, p. 49).
In addition, reporter Mary Chris Jaklevic won an honorable mention from the National Institute for Health Care Management for her story on New Jersey outlier payments ("It's more than just Tenet," July 14, 2003, p. 4).