House Speaker Nancy Pelosi has promised to have a broad economic stimulus plan ready for the President-elect to sign by the time he takes office in January. The package, which could inject as much as $500 billion into large public works programs, has led to a scramble to identify projects that would create jobs and spur economic growth.
Transportation infrastructure and green energy top the list of projects being considered. But using the bill to fuel adoption of health IT, the goal of several nearly-successful attempts to pass health IT legislation this year, is also being weighed, health care officials said.
One strategy would be to attach the Wired for Health Care Quality Act to the stimulus legislation, congressional sources said. The Wired bill, which failed to pass the Senate by unanimous consent this summer, created incentives for health IT adoption, and addressed several security and privacy problems that had long delayed action on the bill.
At the annual conference of the e-Health Initiative in Washington, D.C., this week, health policy leaders voiced caution about driving health IT adoption via a big financial stimulus program.
Dr. Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution, said health IT financing is most productive when tied to specific standards, or functional and performance requirements focused on health outcomes.
Although direct financing of health IT is one way to raise levels of health IT adoption, he said, “I’m not sure that by itself, it would lead to better care,” McClellan said.
Gov. Howard Dean, chairman of the Democratic National Committee and a medical internist, warned that standards and uses of systems underwritten by a stimulus would have to be widely tested and accepted before purchasing started.
“In theory it’s a great idea,” Dean said. “We would just have to make damn sure the system works before we do it.”
Even without the benefit of stimulus legislation, health IT analysts believe 2009 will be a notable year for health IT. Those expectations have been set since the summer, when the Obama campaign released a health are policy outline that called for $50 billion – $10 billion per year for five years -- to fund health IT programs.
In considering the year ahead, health IT experts at the eHealth Initiative conference offered ways the incoming administration's health IT team could make the best use of the money and commitment.
Dr. Jeffrey Kang, chief medical officer of CNA Healthcare and president of the eHealth Initiative, said he believed the health IT community was at an “inflection point” marking what the private sector could accomplish in setting up national health IT systems without greater involvement by the federal government.
“We may have gone as far as we can vis a vis what the private sector can do” without a stronger government stake in health IT, Kang said.
Kang said one of his biggest worries was that consumer privacy concerns would bog down progress on health information streamlining in the coming year. “I’m worried that they won’t be able to figure it out in legislation,” he said.
He proposed that instead of striving for a legislative fix, privacy become the focus of a governance process that addressed privacy policies and security an ongoing basis. “I would propose that they consider privacy more of a process so that these issues could be dealt with as they come up as a matter of rules and administration,” he said.
John Glaser, vice president and chief information officer for Partners HealthCare System, said the government might use the $50 billion to get its own health IT house in order, especially in streamlining how Medicare systems link to health care provider programs and systems.
“Rather than saying to industry, ‘here’s a big check’, perhaps (the government) should look within,” Glaser said.
Andrew Webber, president and chief executive officer of the National Business Coalition on Health, agreed. “Medicare has got to play in the sandbox with others,” he said, “particularly at the local community health level.”
“We can’t access their data,” said Webber, who said a priority should be placed on harmonizing Medicare strategies and approaches with commercial health care providers.
A congressional staffer said a mechanism needs to be set up to give practical assistance to small and medium-sized health providers in setting up health IT systems. Any upcoming health IT legislation should consider an “agricultural extension service” approach to providing business assistance to doctors, she said.
Related story links
- Congressional Democrats are drafting a new health IT bill
- Stark health IT bill calls for Medicare incentives for doctors and hospitals
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Autor(en)/Author(s): Paul McCloskey
Quelle/Source: Government Health IT, 05.12.2008
