Stimulus Debate Shines Light on Health IT Job
Former New York lieutenant governor Betsy McCaughey has caused a stir with a Bloomberg op-ed that raises questions about parts of the economic stimulus package concerning health care and the Department of Health and Human Services.
McCaughey writes that "One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and 'guide' your doctor’s decisions."
"Keeping doctors informed of the newest medical findings is important, but enforcing uniformity goes too far," she writes, maintaining that the plan will limit growth and innovation in the health care industry.
The "new bureaucracy" McCaughey describes is not entirely new: With bipartisan support, President Bush established the National Health Information Technology Coordinator position with an executive order in April 2004. It was established to "to provide leadership for
the development and nationwide implementation of an interoperable health information technology infrastructure," or, basically, to start the transition to electronic medical records.
The coordinator serves as the lead adviser to the secretary of health and human services on health IT issues, and the secretary's office provides the necessary funding for staff and resources. Dr. David J. Brailer was the first national coordinator for health IT and Dr. Robert M. Kolodner currently serves as acting coordinator.
Both the House and Senate versions of the economic stimulus package strengthen the coordinator's role and increase its funding. Should the provisions pass, the coordinator would be tasked with working towards assuring that every American has a "certified electronic health record" by 2014. (The funding is expected to survive the House-Senate stimulus compromise because of its bipartisan support.)
This new effort would provide the necessary funding for the program and ensure the government "a seat at the table" with the health care industry as it develops standards for electronic medical records, said an administration official with knowledge of the stimulus package. The official maintained that the federal government has an interest and obligation to be involved in the process since a transition to electronic medical records would impact the Medicare and Medicaid programs.
The stimulus package includes funding for the health IT coordinator because "Anything related to health care moves the economy forward," the administration official said.
As for who might lead such efforts in the future, someone with the right mix of medical and economic know-how makes most sense, said Ellen-Marie Whelan, senior health policy analyst at the Center for American Progress.
It seems likely that health IT will be a significant part of whatever health care reform is pursued by the Obama administration and that the coordinator's office could see some changes in structure and mission once an HHS secretary is in place. We'll keep an Eye on how the government implements and staffs its plans.
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