President Bush once again mentioned health information technology in his annual State of the Union address Tuesday night, but -- unlike the previous three years -- the reaction appeared to receive more yawns than cheers from the industry.
Scott Wallace, president and chief executive officer of the National Alliance for Health Information Technology and a Bush-appointed chairman of the congressionally mandated Commission on Systemic Interoperability, noted that the Democratic Party rebuttal, delivered by Virginia Sen. Jim Webb, didn't mention health IT at all.
"All of us looking for deep new meaning on the healthcare IT issue in those two speeches were looking in the wrong place," Wallace said. "The starting point is that it's called the 'State of the Union,' but it was really the 'State of Iraq.' Everything else was an afterthought. It was first and foremost a foreign policy speech. ... It doesn't mean Congress or the administration isn't interested in the issue, but that speech was a forum for a different conversation."
The president's speech contained one sentence on heath IT inserted in the middle of two paragraphs containing one-sentence mentions of other healthcare hot-button issues. Here is an excerpt from the transcript:
"Keeping America competitive requires affordable healthcare. Our government has a responsibility to provide healthcare for the poor and the elderly, and we are meeting that responsibility. For all Americans -- for all Americans, we must confront the rising cost of care, strengthen the doctor-patient relationship and help people afford the insurance coverage they need.
"We will make wider use of electronic records and other health information technology, to help control costs and reduce dangerous medical errors. We will strengthen health savings accounts -- making sure individuals and small-business employees can buy insurance with the same advantages that people working for big businesses now get. We will do more to make this coverage portable, so workers can switch jobs without having to worry about losing their health insurance. And because lawsuits are driving many good doctors out of practice -- leaving women in nearly 1,500 American counties without a single OB/GYN -- I ask the Congress to pass medical liability reform this year."
In 2006, the president said: "We will make wider use of electronic records and other health information technology to help control costs and reduce dangerous medical errors," which is similar to what he said in 2005.
Two years ago, Bush had this to say: "I ask Congress to move forward on a comprehensive healthcare agenda -- with tax credits to help low-income workers buy insurance, a community health center in every poor county, improved information technology to prevent medical errors and needless costs, association health plans for small businesses and their employees, expanded health savings accounts and medical liability reform that will reduce healthcare costs, and make sure patients have the doctors and care they need."
In 2004, health IT received its first mention from the president.
"By computerizing health records, we can avoid dangerous medical mistakes, reduce costs and improve care," the president declared in 2004 -- much to the delight of the health IT community. In fact, when David Brailer, the nation's first national coordinator for health information technology, announced his resignation last April, Wallace said these sentences in the State of the Union speech were among Brailer's top achievements.
"Brailer's first major coup was getting healthcare IT mentioned in the State of the Union message," Wallace said last spring.
And while critics may complain that there's been more talk than action, Wallace said these annual mentions have had an impact.
"It's a mainstream issue now," he said. "So, now that we're all in favor of IT, the question is: What are we going to do different?"
Wallace added that it appears the two main issues the administration would like see advanced by health IT are transparency and cost control, but that large financial subsidies will not be forthcoming.
"The president's position has been pretty clear from the get-go: It's a private-sector initiative that can be guided by the federal government, but it's not going to be providing it with any new sources of dollars," Wallace said.
$100 million sentences
He also said that Washington insiders use the president's annual message as a "finger in the air" gauge of how much funding an issue will receive in the next year's budget. According to Wallace, a sentence in the State of the Union address is worth $100 million, while a paragraph translates into $1 billion in federal funding.
In the past, health IT organizations and vendors have issued news releases praising the president for using his State of the Union message to highlight the need for using more technology in healthcare. But, this year, similar statements were hard to find.
In its headline, the news release from the Healthcare Information and Management Systems Society declared that the "President's State of the Union is a Home Run for Harnessing Information Technology to Transform Healthcare." But, in addition to making a baseball reference while most sports fans are focused on the upcoming Super Bowl, the release spent more time discussing health insurance and earmark reform than health IT.
HIMSS did note that earmark reform could have some relevance to the health IT industry, as some members of Congress used the controversial funding mechanism to help finance regional health information organizations. The Chicago-based organization that represents some 20,000 individual members and more than 300 companies also used its release to push for more investment in health IT.
"Compared to other industries, the healthcare sector in the U.S. underinvests in information technology and management system solutions," said HIMSS President and CEO Stephen Lieber in the news release. "Fortunately, new market drivers -- economic as well as political will from the president and his administration -- may positively impact this situation. ... At this juncture in our history, it's time to focus dollars on proven technologies and management systems that save money and improve patient care. HIMSS is pleased that the President remains committed to harnessing the value of information technology to transform healthcare for all."
One IT vendor that issued a news release commenting on the speech was Islandia, N.Y.-based MedLink International.
"HIT is receiving bipartisan support, with numerous policymakers embracing it as a primary opportunity for improving the cost and quality of the nation's healthcare delivery," the MedLink release stated. "As a result of President Bush's State of the Union address, MedLink believes that there will be additional support in Congress for HIT bills and support for the national mandate of electronic health records called for by President Bush in 2004."
What do you think? Write us with your comments at [email protected]. Please include your name, title and hometown.