Presidencies end with criticism, but begin with advice.
President-elect Barack Obama began Wednesday receiving national intelligence briefings and met this morning with an ad hoc committee of financial advisers. So, were not jumping the gun by surveying a sample of healthcare leaders about their expectations as well as their advice for an Obama administration in promoting healthcare IT.
Matt King, M.D., chief medical officer of Clinica Adelante, a community health center in the Phoenix area, is the chairman and director of WorldVistA, a not-for-profit organization promoting the use outside the Veterans Affairs Department of an open-source version of its public domain VistA clinical IT system. King recalled that both Obama and his defeated challenger, Sen. John McCain (R-Ariz.), included healthcare information technology as part of their plans for healthcare reform.
I know that President Obama noted healthcare as one of his top four priorities, King said. The real question is going to be how much is going to be in the budget, given the weak economy. Extending healthcare would have to include a fairly aggressive transition to healthcare IT. Assuming nothing catastrophic happens to the economy, I think its going to be a funding priority. I think theyre pretty interested in innovations.
King said WorldVistA leaders are very happy with the Health-e Information Technology Act of 2008, a piece of pending legislation sponsored by Rep. Pete Stark (D-Calif.), the chairman of the House Ways and Means Health Subcommittee, that calls for the Office of the National Coordinator for Health Information Technology to coordinate the development of an open-source software system for healthcare as a low-cost alternative for safety net providers. It specifically mentions VistA as a possible model.
I think its going to be a good four years for open source, King said.
King said that to demonstrate the power of VistA in his WorldVistA presentations, he uses a chart originally published in 2007 in the Washington Post showing inflation in per capita healthcare spending for VA beneficiaries compared with those same numbers for Medicare and all healthcare recipients between 1996 and 2004. The chart shows almost a flat line for cost increases of less than 1% for VA patients over the period, but a 45-degree angle for Medicare beneficiaries, whose costs increased nearly 45% over the period, and a line nearly as steep for the average person, whose costs went up nearly 40%.
It is pretty jaw-dropping, King said.
Don McCanne, M.D., is a senior health policy fellow with Physicians for a National Health Program, which advocates for single-payer, universal healthcare coverage.
McCanne said, I think that we do need to use IT much more, EMRs and integrated IT systems. As an organization, We havent really pushed IT mainly because its been used in the debate over healthcare reform as a money saver. It probably wont be that. It probably will improve quality, reduce errors and improve some efficiencies. But the other concern we have is the privacy issue, I think thats a problem that they really havent addressed. Once you convert peoples healthcare information into electronics, its very vulnerable. Weve got to secure that information more effectively than what weve done. Youre going to need oversight. -- by Joseph Conn