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Fast Tracking Health-Care Tech Change

Feds present framework, but industry just starts to embrace standards.
Health and Human Services Secretary Tommy Thompson last week declared this the "decade of health-information technology" as the government presented a framework for transforming health care using IT. But at a health summit in Washington where Thompson spoke, it was hard to find anyone who'd be satisfied if it takes that long to make major progress.

"We can save billions in Massachusetts" through the use of electronic health records by doctors in the state, Cleve Killingsworth, president and chief operating officer at Blue Cross Blue Shield of Massachusetts, told summit attendees. Blue Cross Blue Shield of Massachusetts is putting up $50 million for a regional pilot early next year of an E-health-records program that could serve as a model for the rest of the state.

Thompson, too, struck a tone of urgency. While President Bush in April pledged that most Americans will have an E-health record within 10 years, Thompson said, "I think we can do it sooner. And so does the president."

Dr. David Brailer, the national health information technology coordinator, says he wants feedback from the health-care industry about E-records.

Dr. David Brailer, the national health information technology coordinator, says he wants feedback from the health-care industry about E-records.

Photo by David Deal
Dr. David Brailer, the national health information technology coordinator, presented the framework, one of his first official tasks since taking the new position. "We want to create lines we can color into," Brailer said. If the health-care industry "doesn't like these lines, we want to know," he said.

The framework's four main goals: promote the use of electronic health-records and decision-support systems in physicians' offices, connect clinicians so medical records follow patients from one point of care to another, create personal health records that give people online access to their medical information, and improve overall health by expanding public-health monitoring and quality-of-care measurements. The framework also includes the creation of a panel of health-care executives to assess financial incentives to entice health-care providers, who bear the brunt of the costs and disruption of E-health-records systems, to use them.

"We need a business case that shows doctors save as well," says Ron Ponder, CIO of health insurer WellPoint Health Networks Inc. "Doctors are the primary ones we're trying to bring into the modern age."

Thompson also highlighted efforts to develop private-sector certification for health-care business technology. Such a system might let a doctor buying an E-health-records system know it's certified to interact with other systems. "Certification will reduce the anxiety [of] physicians," said Mary Trimmer, a senior VP at Trinity Health in Michigan. "They don't want to invest in systems and then find out theirs doesn't talk with everyone else's."

Several executives of health IT vendors who attended the summit say the industry needs to put aside its proprietary habits and focus on standards-based products and services that let the entire health-care market expand.

The Centers for Medicare and Medicaid Services, as part of government's pledge to lead by example, unveiled a $50 million pilot in grants for local projects, including one in Indiana to build a Web portal for Medicare beneficiaries to access their personal information and, later this year, access information about preventative services, such as cancer screening and flu shots. That pilot test will provide insight into how to most effectively roll out a nationwide program, said the centers' administrator, Mark McClellan. And Medicare is accelerating its electronic drug prescription initiative, promising to have initial standards for E-prescribing by January 2006. Though 2009 remains the official deadline, McClellan hopes this first step will encourage faster adoption of standards.

Thompson, like others, made it clear that paper won't long remain the foundation for a health-records system: "The horse-and-buggy days of manila folders are ending."

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