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Stimulus Debate Shines Light on Health IT Job

By Ed O'Keefe

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.

By Ed O'Keefe  | February 11, 2009; 6:30 AM ET
Categories:  Agencies and Departments  
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Next: Eye Opener: Feb. 11, 2009

Comments

A lot of emphasis is being place on the use of electronic medical records to help lower medical costs. One problem with electronic medical records if the one of privacy, and people are aware of and trying to deal with the privacy issue. But another problem has to do with quality of medical information (and care). Within the past20 years, I have been diagnosed incorrectly at least four times by incompetent doctors, and I shudder when I think that my records with glaring errors will be available to anyone and everyone. What are we going to do to ensure that we have have excellent, rather than mediocre, health care providers?

Posted by: marmac5 | February 11, 2009 8:47 AM | Report abuse

The current system needs reform and wise leadership before more money. The concern for privacy is paralyzing and prevents medical researchers from collecting data (without personal identification). If the system is to lower health costs we need good data to feed back to patients and doctors the effects of treatment and risks that can be prevented. Treatment should not be enforced or denied through denying payments but simply advice of the best medical science and professional peers. Further, the electronic health IT standards should be open not proprietary. A lot of companies or contractors think they can make money from the new system. But no federal money should go to anything that is not open standard and interoperable and affordable by the lowliest clinic or patient. The VA has already done most of the work on this standard. Another point is that every person in the US should carry a flash drive with personal medical information in case of emergency or seeing new medical provider. Each person can protect her privacy that way. The federal government should pay states and local governments to provide these USB flash drives to everyone as soon as possible in this crisis, as that would have an immediate impact on jobs and health care.

Posted by: joeshuren | February 11, 2009 9:21 AM | Report abuse

The problems with American health care are many. No one talks about getting rid of the $40 billion a year in Medicare and Medicaid fraud. And why are so many of us taking so many prescription drugs? Let's go back to the days when they could not be advertised on TV. And I'm very concerned about a national database whose privacy cannot be secured and whose information may not be accurate. We need to be proactive in contacting the White House and members of Congress with our concerns.

Posted by: pyalem | February 11, 2009 10:00 AM | Report abuse

Individuals should have more control over their healthcare not less. The government could help by establishing a more rational pricing mechanism based upon market forces instead of government fiat. They could also speed up the ongoing digitizing of medical records w/ tax incentives for healthcare providers and the technology companies that perform these transitions. People should have the freedom to control their own healthcare. Daschle should focus more attention on doing his taxes adn less on further destroying our healthcare system.

Posted by: fallsmeadjc | February 11, 2009 11:17 AM | Report abuse

This issue (whether for or against) should not be in the Stimulus bill! It should be debated in the appropriate forum as part of a health care package not hidden in the stimulus bill.

Posted by: amr2 | February 11, 2009 11:35 AM | Report abuse

Another point is that every person in the US should carry a flash drive with personal medical information in case of emergency or seeing new medical provider. Each person can protect her privacy that way. The federal government should pay states and local governments to provide these USB flash drives to everyone as soon as possible in this crisis, as that would have an immediate impact on jobs and health care.

Posted by: joeshuren | February 11, 2009 9:21 AM | Report abus

I'm sure having a flash drive would provide instant medical info for the treating emergency room or others but not sure it provides privacy. How? You insert the drive in to the PC to get the info and can just click SAVE right onto their hard drive. Yep.

Posted by: darlenehastings | February 11, 2009 3:27 PM | Report abuse

As you may know, the vast majority of doctors offices and hospitals employ a paper-based medical filing system. PartnerMD, with offices in McLean and Richmond, Va., is one of the first practices in the nation to incorporate electronic medical records, and their physicians urge adoption of this technology nation wide. Patients will benefit once a critical mass of doctors offices use electronic health records to improve accuracy and to collaborate on cases. Visit www.partnermd.com.

Posted by: SUZANNEFulton | February 11, 2009 5:11 PM | Report abuse

Electronic health records have the potential to reduce costs only if they are all linked together (patient centered). All the savings however will accrue to the insurers while the providers bear the expense. How likely is it that those savings will show up as reduced premiums?

Posted by: blw30 | February 12, 2009 9:54 AM | Report abuse

This HITECH Act -- and $20 billion down-payment – is a grand first act toward establishing pervasive electronic health records throughout the U.S. Salting the mine with incentives for Medicare and Medicaid patients surely gets providers using HIT and building an EHR infrastructure (along with streamlining care for seniors and uninsured.)

But, will that Medicare/Medicaid dose be enough to change the system for everyone else, most especially those in their teens, 20’s and 30’s who will benefit most from wellness, preventive care, and complete medical records over their lifetimes? How will such efforts expand beyond rural areas and selected populations? Are we ready to start creating portable records for uninsured children, or are we going to let them slip through the cracks in our imperfect information environment? The goal of comprehensive care first requires comprehensive records.

Learn more: www.healthcaretownhall.com

Posted by: JEngdahlJ | February 12, 2009 11:27 AM | Report abuse

"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."

I don't supposed it matters that this is completely false.

The bill says that the goal is to provide sufficient information TO THE DOCTOR to help guide his or her medical decisions. There is nothing that says the government will have any involvement whatsoever in this "guidance".

McCaughey's statement makes no sense if you think about it for even a second. Why would the coordinator of health information technology have anything to do with medical decisions? The concern of this office is information technology, not medicine. These are computer guys, not doctors.

Posted by: chrisd3 | February 12, 2009 2:17 PM | Report abuse

HHS can't even follow their own guidelines, or train their contractors to follow their guidelines for medicare recipients. How in the world are they going to monitor all of the citizens health records. I agree Electronic Health Records will help but we have the issue of mis-diagnosis, (which happens frequently). I have patients review their records in our office which were received by other physicians or hospitals. Approximately 75% of those records are incorrect in their data. That's huge!!!! The insurers are going to make out like bandits and those who have served this country will be thrown to the wolves. God help us!! We do need reform but we should look at the cause of the problems, not the symptoms.

Posted by: drsdewing | February 12, 2009 9:04 PM | Report abuse

ChrisD3 comment is spot-on!. McCaughey's Bloomberg piece is absolute fiction and not what the National IT Coordinators post is about at all. This is either cheap politicking or plain ignorance on McCaughey's part. Billions are wasted on duplicate tests and radiography, having interoperable information so that your doctor does not irradiate you with unnecessary CT-Scans etc. is what the goal is. There remain some Drs. and patients that have not acknowledged the myth of doctors being able to memorize and give care from their brains alone. It is foolish to believe that medical knowedge and information memorized or illegible is better than easy to access, legible , organized information. Does anyone want your pilot using only memory and no instruments ??? .... There is way to much information for doctors to process on anything more than the routine case. The price of better care are databases that have the potential to be hacked or abused....the tradeoff is the potential for way better care weighed against that digital abuse...i will take the better care and the data that will come from this...this data will likely establish that many therapies and tests are a complete waste of the taxpayers dollar. The data from interoperable records will shine light on a lot of wasted money and a new era for medical knowledge. Data and rational thought trumps paranoia anyday!

Posted by: eblair1 | February 12, 2009 9:05 PM | Report abuse

As a person who has been deeply and permanently harmed by our ugly medical industry and the insipid legislation and MANDATED drugs that we have NOW, I'm against this horrid legislation!
There is NO protection for the end user and this takes away ALL of the little health freedom that we have.
We do NOT need any more MANDATED drugs or more harmful invasive "tests". We do NOT need any more governmental agencies (and this will created many more). We do NOT need any more IT. Are you not able to read the paper? I don't think that we need derivatives in the medical industry.
We cannot afford more Medicaid. We can't even pay for what we are doing now. The drugging and institutionalizing everyone that we don't like to look at, is just stupid and it is costing us big bucks, not just to these individuals, but to everyone.
If the government needs solutions to our financial crisis, they need to stop all of the TV advertisements for dope. We already have an addicted society - and the illusion that dope is good for your health is destroying this nation.
They need to keep Obama's promise to repeal the FDA preemption legislation. This has cost overwhelming numbers of the health and lives of people and has caused the spiral of disability that has occured since it was past four years ago.
What drugs are our politicians on? STOP THIS NOW! Since this is more in-the-dark legislation you need to call TODAY.
You will need these numbers:
Contact Your SenatorsCapitol Switchboard – (202) 224-3121
Or find your Senator’s contact information online by clicking here
The Three Key Senators to Also Contact:
Collins, Susan M. - (R - ME)—Direct: (202) 224-2523, Fax: (202) 224-2693
Specter, Arlen - (R - PA)—Direct: (202) 224-4254, Fax: 202-228-1229
Snowe, Olympia J. - (R - ME)—Direct: (202) 224-5344, Fax: (202) 224-1946

Posted by: kathy6789 | February 13, 2009 12:00 PM | Report abuse

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