As Congress debates how much it should contribute to the funding of a national health information technology network, one thing's for certain: Whatever it budgets won't be enough to satisfy proponents of the system championed by health IT czar David Brailer.
All indications are that Brailer's Office of National Health Information Technology will get substantially more funding--perhaps double the amount it had in fiscal 2005.
But so far, federal lawmakers have played coy with HHS' budget--a narrow swath of which encompasses Brailer's funding. Last week, legislators from both the House and Senate earmarked $61.7 million for Brailer's office only to see it scuttled in the House shortly thereafter, when lawmakers failed to approve the $142.5 billion Labor, HHS, Education and Related Agencies budget.
All of which has rankled some health IT proponents who say that the IT budget's projected increase--although appreciated--is still on the low end of what is needed just to continue to push for a national network that will cost tens of billions of dollars. Some members of Congress, other federal officials and leaders of a wide array of interest groups have been talking up a national electronic medical records system as a critical component of everything from battling avian flu and terrorism to solving medical errors and making the health system more cost-efficient.
Now federal lawmakers have to match funding to that rhetoric, proponents said.
David Merritt, project director for Newt Gingrich's Center for Health Transformation, a for-profit consultancy that has championed the move to electronic medical records, said that Congress needs to "step up to the plate" and start funding health IT as a key component of national security. "It's just a natural fit," he said.
"There's no question the government could very, very valuably spend much more money than we're putting into this," added Don Detmer, president and chief executive officer of the American Medical Informatics Association, based in Bethesda, Md. Detmer, who also served on the Commission on Systemic Interoperability--an advisory group to HHS--said that even the $75 million President Bush budgeted for Brailer's office would have been inadequate. "There are a lot of deliverables and a lot of work that still needs to be done."
The House backed Bush's budget allocation, but the Senate came in with a lower number, roughly $42.5 million. The proposed 2006 budget from a congressional conference committee would effectively split the difference, Merritt said.
Those figures pale in comparison with the amounts other national governments have invested in their health IT infrastructures, Detmer said. Great Britain, for instance, has invested billions of dollars in its national electronic infrastructure. Brailer's office dedicated most of its 2005 budget to pay vendors who were hand-selected to tackle key components for a trial health IT system. Contracts went to groups that would ensure that health IT standards would be uniform, certified and legal across state lines.
Frederick Slunecka, regional president for Avera McKennan Hospital and University Health Center in Sioux Falls, S.D., and a member of the Commission on Systemic Interoperability, said he'd like to see some of the money go toward a functional model of an electronic medical record system.
"Electronic medical records are installed successfully in a number of institutions," Slunecka said, adding that a model that sufficiently connects everything from teaching facilities, community-based hospitals and those in more rural settings hasn't yet come to fruition. "We're really waiting to see one."