Health care IT agenda inches forward

HHS secretary makes a pitch for public/private partnership

Business Roundtable Health IT Leadership Panel Report

Two events last week put new force behind the Bush administration's agenda to develop national information technology systems for health care. A group of top business executives released a report urging the adoption of health information systems as a national priority that demands federal leadership. And federal lawmakers introduced bipartisan legislation that requests $250 million for creating regional health information networks.

Mike Leavitt, secretary of the Department of Health and Human Services, said health care IT is essential to transforming the nation's health care system. Working together, the federal government and the private sector can accelerate changes "that will lead to fewer medical errors, lower costs, less hassle and better care," he said.

Leavitt released a report May 11 that HHS officials wrote with members of the Health IT Leadership Panel of the Business Roundtable, an association of corporate executives. The report recommends that the federal government "use its leverage as the nation's largest health care payer and provider to drive adoption of health IT."

The report estimates that the nation spends $17 billion to $42 billion a year on health care IT, but the use of electronic health record systems nationwide could avoid $112 billion a year in health care spending.

Members of the leadership panel who helped prepare the report included the chief executive officers of some of the country's leading corporations, such as FedEx, General Motors, International Paper, Johnson Controls, Target and PepsiCo.

On the same day Leavitt released the business leaders' report, Reps. Tim Murphy (R-Pa.) and Patrick Kennedy (D-R.I.) introduced a health IT bill, the 21st Century Health Information Act. It asks HHS to award grants totaling up to $250 million to as many as 20 organizations to develop regional health information networks. The government would award the grants during a five-year period.

The bill would also provide up to $5 million a year in funding for a National Technical Assistance Center operated by the Agency for Healthcare Research and Quality. The center's staff would help physicians make the switch to health care IT systems.

Health care IT leaders said the report and bill together provided needed impetus for developing a nationwide health IT system. Janet Marchibroda, CEO of the eHealth Initiative, a health IT advocacy group based in Washington, D.C., said federal officials should use the government's financial clout as the payer of about 32 percent of the nation's health care bills to create financial incentives for physicians and hospitals to adopt health IT. They could do so through programs such as Medicare, which is administered by the Centers for Medicare and Medicaid Services (CMS).

Mike Sommers is chief information officer for Illinois' Cook County Bureau of Health Services, which installed a sophisticated health IT system in 2002 in 30 clinics and three of the county's hospitals. Sommers said CMS should use financial incentives to encourage the use of health care IT, adding that CMS might also try forcing the issue by cutting payments to slow adopters of health care IT.

Funding health care IT as a national priority remains a significant challenge. HHS' fiscal 2006 budget includes only $125 million for health care IT.

Dennis Giokas, chief technology officer for Canada Health Infoway, a government-funded, nonprofit corporation that is leading Canada's health care IT programs, said such investments must be made wisely. Canada's investment of $970 million for health care IT eclipses current U.S. funding levels.

Scott Wallace, president and CEO of the U.S.-based National Alliance for Health IT, agreed that funding should be spent wisely.

"We don't need more money today, but we do need to make sure it is going to the right places," he said.

HealtheVet budget crunched

Members of a House subcommittee gutted President Bush's request for $311 million for fiscal 2006 to launch a health electronic records program known as HealtheVet. The program would modernize the records system for the nation's veterans.

Last week, the House Appropriations Committee's Military Quality of Life and Veterans Affairs, and Related Agencies Subcommittee, approved $11 million for the project next year. The dramatically reduced recommendation now goes to the full committee and the Senate for action.

"The administration asked for $311 million for a brand-new program and had not provided the committee with a single justification," said John Scofield, a committee spokesman. He said the panel's investigators will assess whether the funding is necessary and how it should be spent.

The subcommittee's action is the latest stumbling block for the HealtheVet program. A Carnegie Mellon University report commissioned by the Department of Veterans Affairs said the ambitious program had been poorly planned and had a high risk of failure. Robert McFarland, the VA's chief information officer, said the study had been commissioned to find holes in the project and identify the best way to close them.

In March, the House Veterans' Affairs Committee recommended cutting $400 million from the VA's proposed information technology budget for 2006, including start-up funds for HealtheVet. Chairman Rep. Steve Buyer (R-Ind.) said at the time that the project should not be funded until officials answered all questions about its problems.

— Judi Hasson

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