Congress Chops $50 Million For E-Health-Care Funding

National health-care IT director says $50 million shortfall could put electronic health-records plan in jeopardy.

Government-funded E-health initiatives could face a disappointing setback in fiscal 2005, because Congress failed to approve $50 million that had been sought by the nation's health IT czar for projects earmarked to help build a national health data exchange.

After months of haggling over trillions of dollars and hundreds of government projects, Congress eliminated from its omnibus federal spending bill a relatively modest $50 million request by national health IT coordinator, Dr. David Brailer, for seed projects to wire the nation's health-care system. In a teleconference with health-care executives on Monday, Brailer said that $50 million for technology projects was a line item submitted last winter to Congress for the fiscal 2005 budget, months before Brailer took office in May as the nation's first health-care IT coordinator, a position created by President Bush via an executive order in April.

"This office wasn't conceptualized when the line item was submitted," he said. Once in the job, Brailer said, "I grabbed that item and called it my own." Congress chose not to approve the funding despite public enthusiasm for E-health initiatives in recent months by bipartisan members of Congress, health-care industry leaders, and the Bush administration. Brailer, a newcomer to Washington politics, acknowledged that he didn't personally lobby hard to get the line item approved. "I'm more of a maven than a salesperson," he said. "I need to be a better salesperson, given our appropriation."

The failure to get the Congressional funding is a setback, Brailer said. It's possible his office could get obtain some financing for the earmarked projects through the Department of Health and Human Services' $500 billion budget, which includes $60 billion in discretionary spending. The $50 million sought by Brailer's office was in addition to another $50 million approved for health IT grants awarded by the Health Department's Agency for Healthcare Research and Quality, primarily for rural community E-health projects.

The $50 million sought by Brailer had been designated for projects related to three key areas: regional health information efforts; standards to promote interoperability among regional networks; and seed money for a product -certification program to ensure that health IT products meet standards for interoperability. Without details and standards for interoperability being worked out soon, the nation risks having health-care providers investing in E-health records systems that can't share information with one another, Brailer said.

Brailer said his office is "undeterred" by the fiscal 2005 budget disappointment and that it's focusing attention already on fiscal 2006, "which very much matters." However, Brailer admitted the failure of 2005 funding puts the timetable for E-health-care records in question. "If they don't start soon, the overall timetable is at risk," Brailer said. Earlier this year, President Bush set out a national goal for most Americans having electronic health records in 10 years. Brailer had said publicly in recent months that he thought that goal was attainable in about seven years.

Government researchers estimate that health IT such as E-health records potentially could save billions of dollars and tens of thousands of lives each year through reduction in paperwork and medical errors.

In related health IT developments, Massachusetts governor Mitt Romney said on Monday it was his goal to have most hospitals and health-care providers in the state adopt E-health records over the next five years. He formally disclosed the creation of a nonprofit entity, Massachusetts eHealth Collaborative, representing 34 of the state's key health-care stakeholders, to lead the E-health records push.

Blue Cross Blue Shield of Massachusetts is investing $50 million to enable the collaborative to expand electronic health records across the Bay State. Pilot E-health-records projects in three yet-to-be-chosen communities will be launched next year.

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