In 2005, U.S. Sens. Debbie Stabenow (D-Mich.) and Olympia Snowe (R-Maine) proposed spending $4 billion on healthcare IT over five years, sums that dwarfed all other legislative proposals at that time, such as legislation by then-Sens. Hillary Rodham Clinton (D-N.Y.) and Bill Frist (R-Tenn.) for $655 million over five years. Neither bill went anywhere, and no major IT spending legislation has passed since as the Bush administration set high goals for IT adoption but chose to rely on market forces to make adoption happen. But hospital adoption of electronic health-record systems has lagged. According to HHS-funded research, even after four years of administration IT jawboning, just 1.7% of hospitals surveyed had fully implemented a comprehensive EHR across all units of their hospitals and only 7.9% had implemented a basic EHR system; just 4% of physicians in ambulatory-care facilities have a fully functional EHR available, while only 13% had an EHR with the basic functionality.
Even the $20 billion supported by the Business Roundtable is a fraction of the $115 billion needed over a 15-year adoption period for hospitals and physician offices to reach an EHR adoption rate of 90%, according to estimates in a 2005 RAND Corp. study. But the estimated investment potential is huge, with Medicare alone averaging $23 billion a year in savings over the 15-year period while private payers would average $31 billion a year, according to RAND.
The Business Roundtable also is breaking with the Bush administration approach that relied on government encouragement and consensus-building toward industry adoption of healthcare IT standards. HHS Secretary Mike Leavitt created a public-private advisory panel called the American Health Information Community and the Healthcare Information Technology Standards Panel to work on reaching consensus on IT standards. The HITSP is HHS-funded but dominated by representatives from the private sector.
In contrast, the business groups leaders also called for HHS to mandate the use of healthcare IT standards in its Medicare and Medicaid programs.
Business Roundtable President John Castellani said the organization has been very supportive of what Leavitt has done, but where we would suggest that it would be enhanced is that the standard itself be driven by HHS. Castellani said the standards should be implemented within the Medicare program.
Seidenberg was even more emphatic, specifically saying there needed to be a government mandate to use healthcare IT standards.
He called on Congress to jump-start the market and create real change. The fact is, we just cant wait any longer for health IT.
Seidenberg cited the 1999 Institute of Medicine report that estimated 98,000 people die in hospitals each year from preventable medical errors and the conventional wisdom that some of them could be stopped by implementations of IT systems with medication alerts and other forms of computerized decision-support tools.
Business knows how to do it, he said. By starting with the government side of this, its terrific. It will create all the energy you need.