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10/16/2009
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Baucus Bill Champions Healthcare Technology

Legislation just sent to the floor by the Senate Finance Committee includes recommendations encouraging rapid adoption and use of health IT systems.

Much of the public discussion surrounding the new healthcare bill has focused on its costs and its insurance provisions -- notably, the prohibition against insurance companies denying coverage to people with pre-existing conditions. The legislation was just sent to the Senate floor for a full vote after approval by the Senate Finance Committee

The legislation is being referred to as the Baucus Bill, after Sen. Max Baucus, D-MT, who heads the Senate Finance Committee and championed the bill.

However, the bill also takes a significant stab at setting the technological agenda for the U.S. healthcare system of the future. It includes recommendations encouraging rapid adoption and use of health IT systems.

A summary of the bill (available here [pdf download]) includes more than a dozen references to technology. Much of the verbiage is devoted to advocacy for electronic medical records (EMR). Computerized patient data is seen as a key to making care more efficient.

It's also envisioned as a feeder into so-called "grouper" technology, where success rates for different treatments can be determined by analyzing large chunks of data.

Notes the summary: "Health IT is needed for quality reporting and improvement and to give providers ready access to better evidence and other clinical decision-support tools. Reinvesting in the training of a twenty-first century health care workforce is necessary for many delivery system reform goals to be realized."

The most detailed take out on the bill's healthcare IT intentions are contained in this lengthy passage on pg. 57 of the summary:

"Health Information Technology. Most providers in the health care system collect and transmit information on paper, over the phone, and via fax machines. More advanced health information technology (IT) offers tools to streamline and support the process of collecting and analyzing the data needed to provide the best and most efficient care possible. Clinical IT comprises multiple applications that can support different functions in health care, such as:

  • Tracking patient care;

  • Allowing physicians to order medications, lab work, and other tests electronically, and then access test results;

  • Reporting to chronic disease registries; and

  • Providing evidence-based decision support to physicians.

    Encouraging more rapid adoption and use of health IT systems will improve health care quality and make our health care system more efficient.64,65 Automating the collection of clinical data will also be a vital component of better quality performance measurement and reporting. Technology can facilitate richer data sets for comparative effectiveness research, and help providers use comparative effectiveness findings in their own clinical practices. The Baucus plan provides Federal-level leadership to spur the modernization necessary to support a truly patient-centered delivery system.

    Health IT adoption by providers has been low to date, especially for physicians in small group practices. Providers, particularly physicians, cite as obstacles the cost of purchasing and implementing systems, a fear of investing in systems that may soon be obsolete, as well as a lack of a clear return on investment. Some providers, especially in smaller settings, lack the resources or expertise to navigate the large and complex market of health IT products or to maintain such a system over time. Implementing health IT also requires changes in office organization, processes, and culture that clinicians and office staff may resist. Safeguards must be put in place to ensure that patient privacy is protected. And existing payment incentives discourage health IT adoption. Reductions in office visits, hospital admissions, and other services that could be achieved through the use of health IT would accrue to the benefit of payers and patients but not to providers themselves.

    Despite these challenges, there is a growing consensus among patient advocates, providers, and payers that a path forward that drives adoption and protects patient privacy must be found."

  • InformationWeek has published an in-depth report on e-health and the federal stimulus package. Download the report here (registration required).

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