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6/18/2004
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Industry Must Improve Its Technology Use

'Son of HIPAA' regulation is possible if companies don't get moving on IT.

There's a growing sense among members of the health-care industry that if they don't take action soon to better use IT to improve health care and lower costs, the federal government will dictate policies and possibly even tech standards. And it's a sense of dread, thanks to the fresh memory of the Health Insurance Portability and Accountability Act, a set of tough federal rules governing the way medical information is gathered, stored, shared, and protected that has forced considerable compliance-related spending.

Electronic medical records hold second-tier status to technologies like MRI, national health-care IT coordinator Dr. David Brailer said. Photo by Bob Severi/Getty Images.

Electronic medical records hold second-tier status to technologies like MRI, national health-care IT coordinator Dr. David Brailer said.

Photo by Bob Severi/Getty Images
Dr. David Brailer, a doctor and former health-care executive appointed in May as the nation's first national health-care IT coordinator, said last week he'll try to help the industry take action itself so government doesn't step in unnecessarily. "I don't want to see a Son of HIPAA put into law," Brailer told the National Alliance for Health Information Technology in Chicago.

Brailer, who was appointed as part of President Bush's pledge to establish electronic medical records for the majority of Americans within 10 years, said his office will have a strategic plan by July 21 for guiding the health-care industry toward an interoperable health IT infrastructure and electronic medical records.

More than 90% of about 30 billion health transactions a year are done by phone, fax, or mail, and 40% of surveyed health-care organizations last year planned to spend 1.5% or less of their operating budgets on IT, Janet Marchibroda, CEO of the nonprofit eHealth Initiative, told a House Ways and Means Subcommittee hearing last week, where Brailer also testified.

Brailer in his speech noted that electronic medical records hold second-tier status to technologies such as MRI, which is part of why they've been slow to be adopted in the cash-strapped health-care system. "An MRI makes [doctors'] reasoning more fact-based. That's exactly what information technology does at the point of care with electronic health records," he said.

One step the private sector must take is to establish an organization to certify electronic records and related IT systems, Brailer said. If it doesn't do so quickly, he added, the government would create something similar to the Food and Drug Administration to do it.

Brailer highlighted key elements that will shape his group's effort to spur the effective use of IT in health care: supporting automation of health-care practice, interconnecting systems so patients' data moves with them, personalizing health-care information, and improving the overall population's health.

Most in the health-care industry want some government involvement in IT. The lack of interoperability standards makes companies wary of investing for fear their systems won't be compatible, said Dr. Andrew Wiesenthal, associate executive director of Kaiser Permanente, which is in the midst of a 10-year, $3 billion effort to create an IT infrastructure. The federal government could financially support public-private efforts to set standards and help develop them in its role as a provider and buyer of health care, he said.

Brailer said he believes the government will pay its share for a health IT infrastructure, but that the private sector needs to step up as well: "The federal government isn't going to write a check that makes it all happen."

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