Obama Gears Up For Health Reform With Health Information Technology
Obama Gears Up For Health Reform With Health Information Technology
On Saturday, in his weekly radio address to the nation, President-elect Barack Obama proposed modernizing the health care system by investing in “cutting edge technology and electronic medical records“:
In addition to connecting our libraries and schools to the internet, we must also ensure that our hospitals are connected to each other through the internet. That is why the economic recovery plan I’m proposing will help modernize our health care system – and that won’t just save jobs, it will save lives. We will make sure that every doctor’s office and hospital in this country is using cutting edge technology and electronic medical records so that we can cut red tape, prevent medical mistakes, and help save billions of dollars each year.
Less than 25 percent of hospitals, and less than 20 percent of doctor’s offices, employ health information technology systems (HIT). Estimates vary, and real-life experience is limited, but one group of researchers found that implementing health IT would result in mean annual savings of $40 billion over a 15-year period.
A fragmented health care system, “difficult-to-demonstrate HIT return on investment, and first-mover disadvantage” help explain why the market has failed to deliver HIT and underscore the importance of Obama’s leadership on the issue. For instance, while insurance companies, to a greater extent than providers, “could benefit from reduced costs in moving from a paper-based system to electronic health records,” the costs of implementation are far higher for providers. An analysis by the Center for Information Technology Leadership (CITL) found that “while providers are footing the bill for HIT, they may experience only 11 percent of the potential gain. Other stakeholders, payers principally among them, may reap 89 percent of the gain.”
Until gains are distributed a little more equally, medical providers will resist adopting HIT. Fortunately, the federal government, along with several state governments, have begun investing heavily in HIT systems. The Veterans Affairs Administration’s successful VISTA system “has had a profound influence on the quality and efficiency of clinical care and data management in the nation’s veterans hospitals.”
Meanwhile, in Pennsylvania, Gov. Ed Rendell (D-PA) has established the Pennsylvania Health Information Exchange Governance Structure to develop and manage a statewide electronic health record system. Gov. David Paterson (D-NY) announced in 2008 that his state awarded $105 million in grants for the development of health information technology and Gov. Janet Napolitano (D-AZ) signed an executive order in May 2008 directing state agencies to work with the Arizona E-Health Connection to promote the expansion of e-prescribing.
Still, the greatest HIT innovations may belong to the Taiwanese. As T.R. Reid reported in his ‘Sick Around The Word‘ documentary, “Taiwan designed its new health system using state-of-the-art information technology”:
Everybody here has to have a smart card like this to go to the doctor. The doc puts it in a reader, and the patient’s history, medications, et cetera, all show up on the screen. And then the bill goes directly to the government insurance office and is paid automatically.
As a result, Taiwan has the lowest administrative costs in world, less than 2 percent. In the United States, administrative costs eat up 22 percent of health care spending.
4 Responses to “Obama Gears Up For Health Reform With Health Information Technology”
Register
RSSLogin
Topic Cloud
ArchivesBlog RollAbout Wonk RoomContact Us
Donate
“Modernize” under Republicans meant privatize. It’s unclear what Obama means. The Taiwan example is the exact opposite of Bush’s health care reform plans, which failed miserably.
Automation does nothing to address the mix of primary care doctors vs. specialists in the nation’s residency programs.
While electronic records offer tremendous potential cost savings, HIPAA restrictions and system interoperability are barriers.
The question remains as to who wins in healthcare reform. Employers badly want to dump their health insurance benefit. For-profit healthcare has its own agenda, different from nonprofit/teaching hospitals. Physicians will look after their interest, as will health insurance companies.
It will be an interesting battle. But rest assured, pay for performance will have the same distorting impact as CEO incentive compensation. Providers need to focus on improving quality, not on optimizing payment.
December 8th, 2008 at 7:27 pmThe numbers of doctors’ offices and hospitals that have some sort of electronic records (<20% and <25% respectively) is probably too high, since some proportion of both are systems that are incompatible with other systems, and would probably have to undergo major reworkings or be replaced before they could be part of a national “system.”
One major concern that gives me shivers whenever anybody talks about electronic records is that nobody seems to be talking concurrently about quality control, which will be even more critical when dealing with medical records than elsewhere:
Think about all the times in your life when you’ve dealt with some clerk about a billing error at a store (or something of that sort), only to be told something along the lines of “but the computer says …, so it must be so.” Now imagine trying to correct a computerized error about a medical problem you don’t have, or an omission of a major disease or medication from your records. Think about all this, and you’ll understand why I regard medical records as a very mixed blessing.
The IRS has been trying for decades to get a major computer system in place, and hasn’t accomplished that yet. So, before we rush headlong into the Federal government leading an effort to “modernize” medical records, think about something even worse than the IRS.
December 9th, 2008 at 9:38 amS1: The marginal utility of a records-keeping system is a function of its accuracy, privacy, and accessibility by medical professionals you have authorized. Just because some systems have fallen short of the goals in some of those areas doesn’t mean that database programmers should give up, or that RFP writers shouldn’t try to do better.
December 9th, 2008 at 11:16 amIts just another way for Big Brother to control you. RZST
February 5th, 2009 at 5:54 am