Bush's IT Prescription

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The call came out again from President Bush for physicians and hospitals to boost efficiency by jumping on the electronic medical record bandwagon. At The Cleveland Clinic under a banner reading "Better Healthcare, Better Technology," Bush called for a doubling of federal funds in FY05 to $100 million to promote healthcare IT—which government analysts estimate could cut 20 percent from the $1.6 trillion U.S. annual health bill.

The long-term vision is a totally interconnected electronic information infrastructure in which all information about a patient from any source could be securely available to any healthcare provider when needed, while assuring patient control over privacy. Of course it's the getting there that's the challenge - and it's the necessary planning and infrastructure that Uncle Sam will pay for. For fiscal 2006, the White House is asking Congress for $125 million.  

To put healthcare's IT investment in perspective, most industries spend $8,000 per worker on IT. Healthcare spends about $1,000 per worker, the president said last spring.

As you know, Bush launched his healthcare IT initiative last year in his state of the union address that proposed $50 million within HHS for the Office of the National Coordinator for Healthcare Information Technology, which David Brailer, MD, was later named to head. (Congress failed to fund the requested $50 million, but Bush and Dr. Brailer are now urging Congress to reprogram money to fund it.) Dr. Brailer is a keynote speaker at this month's HIMSS meeting in Dallas.

Logistics aside, once appropriated, the money is slated to pay for healthcare IT demonstration-based studies to assess costs and benefits of public and private sector investments and practices, to help develop technology standards, research human-machine interfaces and enable the incorporation of SNOMED-CT into EHR systems, among other initiatives. In 2007, the government is expected to start providing grants, loans and pay-for-performance initiatives (which CMS is starting to pilot at 10 sites) to spur healthcare IT adoption. The Cleveland Clinic is one of the facilities helping to develop standards, and a $3 million grant recipient.

Legal barriers to sharing EHR systems by physicians and hospitals, such as the Stark Law (physician self-referral), also would be addressed.

The government's role in healthcare IT is a facilitator to create favorable market conditions, including amassing government resources, to make it easier for healthcare providers to begin using technology. As Bush posed at Cleveland Clinic: "The fundamental question facing the country is can we have a healthcare system that is available and affordable without the government running it? Absolutely.

For more details, visit www.itrd.gov/pitac/meetings/2004/20040617/20040615_hit.pdf