Like never before, healthcare information technology has become a hot topic on Capitol Hill and even in the White House. Earlier this month, President Bush advanced the cause when he set the goal of equipping everyone in the nation with a personal, portable electronic medical record within 10 years.
After the president's announcement, HHS Secretary Tommy Thompson hastily convened a summit in Washington to solicit advice from the industry on how to move hospitals and doctors toward technology that makes automated teller transactions possible but has somehow eluded most healthcare providers.
"For healthcare IT, the 21st century starts today," Thompson told the crowd he assembled at the Willard Hotel for a town meeting-type event that also featured remarks by Veterans Affairs Secretary Anthony Principi, CMS Administrator Mark McClellan and former Speaker of the House Newt Gingrich.
On Capitol Hill, at least five bills designed to encourage adoption of new systems and set information exchange standards are pending. None would directly link Medicare payments to providers' use of information technology, but some prominent lawmakers see no other way to reach the ambitious goal of widespread adoption.
`We can't take 10 years'
The federal reimbursement system "is very old-fashioned," Rep. Nancy Johnson (R-Conn.), chairwoman of the House Ways and Means Committee's health subcommittee, said at the HHS summit. "If we continue to pay that way, we will not be able to spread technology through the system." Referring to Bush's 10-year goal for broad adoption of electronic records, "We can't take 10 years, with all due respect," Johnson said.
Johnson is one of several lawmakers who has sponsored healthcare IT legislation in recent months. Johnson's bill-introduced in July 2003 and co-sponsored by two Democrats and 14 Republicans-would, among other things, direct HHS to develop a strategic plan for building a Modern Healthcare IT infrastructure.
As much as Johnson and others would like to see that bill signed into law, the prospects are not good in a year when lawmakers' attention is distracted by issues involving the war in Iraq and the upcoming election.
"It's tough to talk about additional legislation this year," House Ways and Means Committee Chairman Bill Thomas (R-Calif.) said recently. "We're just now beginning to see implementation of the Medicare bill."
That bill, which became law last December, takes preliminary steps toward greater industry automation. Among other things, the law requires HHS to develop electronic-prescribing standards by Sept. 1, 2005; establishes the Commission on Systemic Interoperability to guide adoption and standards strategy for information technology; and authorizes grants to help physicians buy and install electronic prescription drug programs.
Lawmakers are starting to understand the link between IT and quality, observers say, and policy will continue to reflect that realization.
"This is not a discussion about IT per se but a discussion about how you transform patient care, quality and value and use IT to serve that master," says Jack Ebeler, president and chief executive officer of the Alliance of Community Health Plans in Washington, which is working with its members on the "Advancing Better Care Project" to promote quality reporting, self-care and effective use of IT.
Another vocal proponent of expanding IT in healthcare is Sen. Hillary Rodham Clinton (D-N.Y.), who has also sponsored legislation. Her bill would require the development and use of standard quality indicators, as well as efforts to increase IT adoption while protecting the privacy and security of information.
"Information technology has radically changed business and every other aspect of American life. It's time we use it to change healthcare," Clinton told an audience at the American Hospital Association's annual meeting in Washington.
Gingrich, a longtime supporter of better information technology in healthcare, said payment incentives are critical to spur physician adoption. Asked by an audience member at the HHS summit how physicians can be prompted to buy in, Gingrich said, "You pay them."
For instance, Gingrich argues, physicians providing seniors their "welcome to Medicare physical" should be paid more for filing and maintaining an electronic health record. As for where the money would come from, Gingrich adds: "It is inconceivable that the electronic health record is not a money-saver overnight."
According to Gingrich's estimate, a national health information network would save as much as $140 billion annually through improved care and reduced duplication of medical tests.