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Government Outlines Health-Care Transformation Via IT

The effort will include improved IT infrastructure, including electronic health records and a network to link them.
The federal government Wednesday laid out a 10-year outline to push a transformation of the delivery of health care through improved IT infrastructure, including electronic health records and a network to link them.

Led by Health and Human Services Secretary Tommy Thompson, who declared this the "decade of health information technology," government officials laid out the framework at a Health Summit in Washington. "The horse-and-buggy days of manila folders are ending," Thompson said.

Thompson has been a vocal champion of accelerating the use of IT ever since President Bush earlier this year created the position of national coordinator for health IT within his department. The new coordinator, David Brailer, presented a report Wednesday aimed at the mission of accelerating health IT adoption. "We want to create lines we can color into," Brailer said. "If you don't like these lines, we want to know."

Among the announcements:

• Thompson will appoint a panel to assess costs and benefits of health IT, with a report due in October. He also disclosed efforts to develop private-sector certification for health IT. Such a system might let a doctor buying an E-health records system know that the system is certified to interact with other systems.

• Medicare plans to create an Internet portal to allow beneficiaries to access their personal Medicare information. It would also accelerate regulations for E-prescribing of drugs in order to quickly disseminate common standards.

In his report, Brailer laid out four main goals for health-care IT, which he outlined in a speech in May. The goals as summarized by the report are:

• "Inform clinical practice": Bringing information tools to the point of care, especially by investing in electronic health records systems in physician offices and hospitals

• "Interconnect clinicians": Building an interoperable health-information infrastructure, so that records follow the patient and clinicians have access to critical health-care information when treatment decisions are being made

• "Personalize care": Using health IT to give consumers more access to and involvement in health decisions

• "Improve population health": Expanding capacity for public-health monitoring and quality-of-care measurement, and bringing research advances more quickly into medical practice

The incentives being considered to entice doctors to adopt E-records include grants, low-interest rate loans, and extra Medicare reimbursements to doctors who use electronic health records. It's the government's aim to lead others in the industry by its example, says Brailer.

Already, some private-sector payers, including some Blue Cross Blue Shield organizations, are beginning to test reward plans for doctors who use electronic health records. In the long run, incentives from the payers to doctors who use E-health systems can greatly reduce payers' other costs, especially by eliminating redundant testing, paperwork, and complications caused to patients by medical mistakes that occur when doctor and nurses don't have access to timely, accurate, comprehensive, and legible information.

"We can save billions in Massachusetts," through the use of electronic health records by doctors in the state, says Cleve Killingsworth, president and chief operating officer at Blue Cross Blue Shield of Massachusetts, told summit attendees. Blue Cross Blue Shield of Massachusetts is funding a pilot for a regional E-health record program early next year in one Massachusetts community, which could serve as a model for the rest of the state.

Don Woodlock, a speaker at the conference and the general manager of GE Healthcare Technologies' Ambulatory and Acute Care business, agrees that doctors especially need to be rewarded for the massive workflow and practice changes that are required when paper-based record keeping is replaced by digital patient charts. "Physician offices have the most difficult time in adopting this. Incentives should be focused primarily on doctor offices," he says.

Ron Ponder, CIO of health insurer WellPoint Health Networks Inc., agrees the industry must prove to doctors that they can benefit by spending on IT. "We need a business case that shows doctors save as well. Doctors are the primary ones were trying to bring into the modern age," Ponder says.

Mary Trimmer, a VP at Trinity Health in Michigan who attended the summit, says doctors would likely welcome the idea of product certification. "Certification will reduce the anxiety by physicians. They don't want to invest in systems and then find out theirs doesn't talk with everyone elses'," she says. Several executives of health IT vendors who attended the summit say the industry needs to put aside their proprietary habits and refocus products and services around standards and best practices that enable interoperability and easier process changes.

Technology product vendors need to refocus their sights from competition based on proprietary products and instead "look at the bigger opportunities" that come from creating a much-larger population of health-care providers that start investing in standards-based systems, says Dan Garrett, VP and managing partner of Computer Sciences Corp.'s global health solutions unit. IT services firms, meanwhile, also need to "open up their intellectual property" of best practices that can help the health-care industry transform more quickly and more uniformly, says Garrett.

As part of the government's mission to lead by example, the Centers for Medicare and Medicaid Services announced at the summit $50 million in grants for local efforts, including a pilot in Indiana to build the 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 will provide insight into how to most effectively rollout a nationwide program, said the center's administrator Mark McClellan. Even Medicare beneficiaries who do not use computers can benefit from the portal, he says, because they can get access to the information through Medicare's consumer help phone line.

In addition, Medicare and Medicaid are accelerating their electronic drug prescription initiative. Originally, Medicare aimed to have E-prescribing based on national standards mandatory by Medicare-participating drug plans by 2009. However, CMS will require an initial set of standards be used by January 2006. McClellan says it's hoped that the first step toward E-prescribing standards by Medicare will encourage more widespread adoption throughout the industry.

Finally, in a move that signals both parties are embracing the general goal of digitizing America's healthcare system, U.S. Rep. Patrick Kennedy, D-R.I., on Wednesday introduced legislation aimed at "transforming the technological backbone of the American health-care industry by 2015." The bill would create "a series of interconnected regional health information networks that also enable patients and provider to share information in a secure manner."

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