The U.S. got off to a late start and is more than a decade behind some other industrialized countries in creating a national healthcare information technology system, meanwhile, the U.S. government and its devotion to a private-sector-dominated approach is spending cents on the dollar on healthcare IT compared with several other nations, according to research published in the May/June issue of Health Affairs.
Just as the U.S. government of late has begun to focus on IT as a way to control rising healthcare costs, "Other countries have accepted the idea that HIT will lower health spending and improve outcomes," but "they are at least four to 13 years ahead of the United States in initiating national HIT programs," according to the article, whose lead author is Gerald Anderson, professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health in Baltimore.
The U.S. spends more on healthcare than every other country in the 30-nation Organization for Economic Cooperation and Development. In the U.S., 15 percent of the gross domestic product was spent on healthcare, while the median for the OECD countries was 8.4 percent.
Citing a lack of rigorous studies proving a connection between cost reduction and healthcare-IT adoption, the authors concluded that simply because the U.S. trails in national IT spending, one can't conclude there is a direct relationship in its relative performance in spending on care.
"However, to the extent that HIT systems are cost-saving in the long run, the lack of an integrated, national IT system for healthcare in the future could exacerbate the position of the United States relative to countries that are HIT leaders," the report said.
The authors noted that although President Bush created the Office of the National Coordinator for Health Information Technology in April 2004, Congress zeroed out the ONCHIT budget in fiscal year 2005, forcing the administration to shuffle money around in the HHS budget to keep the office operational. Outgoing national IT coordinator David Brailer said in a recent interview that it was "only clear in retrospect how big we were set back when our budget was turned back to zero." The office was doing well before the cutback, and managed to recover, but "in the middle (it) was just terrorizing. The overall viability of this program was teetering in the balance."
According to the Health Affairs article, by the beginning of 2006, the most prominent U.S. legislation for healthcare IT proposes authorizing $125 million for fiscal 2006, $155 million for fiscal 2007 and such sums as necessary for 2008-2010, which the authors say "represents only a small proportion of the resources that will be needed to create a fully operational HIT system," citing a recent RAND Corp. study that placed the bill at $156 billion over a five-year period with $48 billion more needed for operating costs.
Germany was the first to head down the healthcare IT road in 1993, according to the authors, and they are expected to complete the task this year, updating a system based on smart-card technology. A nation of 82 million, Germany has spent an estimated $1.88 billion as of 2005 on its healthcare IT system at a cost of $21.20 per capita, compared with $125 million in the U.S. and 43 cents per person. Other national IT spending programs referenced in the report, by country, date of beginning, total spending today by 2005 and per capita expenditures are: Norway, 1997, $52.2 million or $11.43 per person; United Kingdom, 2002, $11.5 billion, $192.79; Australia, 2000, $97.9 million, $4.93; and Canada, 1997, $1 billion, $31.85.
The authors note that public perception regarding privacy and security issue are "critical to HIT adoption" and in the U.S., "70 percent of the ... population remains concerned that sensitive personal information could be leaked because of weak security."
What do you think? Write us with your comments at [email protected].