Analysis: Health IT a bipartisan issue?

WASHINGTON, June 5 (UPI) -- Health information technology may be the first aspect of healthcare reform to wriggle through the political labyrinth surrounding the issue and find consensus, IT advocates said Tuesday.

Electronic record-keeping has emerged as one of the least controversial aspects of the healthcare debate, possibly yielding some of the highest dividends for the lowest cost, but its implementation comprises a less agreeable issue.

In 2006 a bill proposing measures to speed up health IT usage, the Health Information Technology Promotion Act, failed to make it through Congress, bogged down by patient privacy and funding concerns. But supporters of government involvement in health IT have high hopes a similar bill, sponsored by Sens. Edward Kennedy, D-Mass., and Michael Enzi, R-Wyo., will garner greater bipartisan support this year.

The new legislation is still in the drafting stages, but its backers hope a finished bill will be designed to push health IT forward faster by addressing current stumbling blocks like giving different computerized records systems the ability to "talk" to each other and making electronic medical records affordable to doctors with smaller practices.

"We think the 110th Congress has the immediate opportunity to help with legislation to encourage the adoption of health IT," John Engler, president of the National Association of Manufacturers and former Michigan governor, said at a news conference Tuesday announcing the formation of Health IT Now!, a coalition pushing for rapid deployment of healthcare information technology.

Member businesses of NAM have relayed concerns about the rising cost of healthcare to the organization, Engler said, and many believe health IT constitutes an important cost-reduction tool.

"Manufacturers understand and work with technology every day," he said. "Medicine does too, in the operating room ... but in the physician's office, we're stuck on paper -- reams and reams and reams of paper. It's 17th century technology."

In fact, widespread use of medical information systems could save about $81 billion annually, according to the RAND Corp., a non-profit research organization. In addition to electronic medical records, health IT includes computerized physician medication orders and other integrated data sources. Together, these systems could also increase quality of care, while reducing medical errors and administrative headaches.

For individuals with complex medical histories, keeping track of paper records can be a nightmare. For example, Courtney Queen, a 10-year-old from Nashville with a rare disease, had to wait four hours for a procedure during one of many hospital visits because no one had time to lug her extensive files upstairs.

"Four hours after the nurse had called for the medical records, a very small, frail lady, who would not have been able to carry the amount of paper records that Courtney had, came pushing into Courtney's intensive care room a wheelchair filled ... with records," Jennifer Queen, Courtney's mother, told attendees at the conference.

The hospital where Courtney now receives her primary care uses an electronic system, alleviating much of the stress inherent in her previous hospital trips, Queen said.

"We've experienced firsthand what an amazing difference this technology can make in a child's life -- in a family's life," she said.

Supporters of government intervention hope the problems plaguing paper records will unite policymakers from both sides of the aisle.

"This is an area where there should be no disagreement," said former Sen. John Breaux, D-La., co-chair of Health IT Now!

In order to push this year's health IT legislation through Congress, Enzi told United Press International he plans on following an "80-20 rule."

"We can agree on 80 percent of the issues, and we can agree on 80 percent of each issue, but we may never reach an agreement on the other 20," he said. "I will continue to follow the 80-20 rule as we work on legislation to help form a nationwide health information technology system to improve the quality of healthcare in this country, avoid duplicative tests, reduce medical errors and cut costs."

A number of issues need to be addressed by legislation aimed at increasing health IT. Incompatibility between various systems constitutes one of the chief hurdles impeding widespread deployment of the technology.

"Interoperability is our very first principle," Joel White, director of Health IT Now!, told UPI. "We need a process for adopting interoperable systems, just like how IBM (computers) can talk to Macs."

Federal standards for system interoperability, product certification and quality measures should be established by Congress in order to decrease risk for practitioners and encourage adoption of new systems, White said.

But federal regulation alone won't do the job, said former Rep. Nancy Johnson, R-Conn., co-chair of the coalition.

"We do need to put money on the table to demonstrate that the public interest will be served as the nation goes to a nationwide information system," she told UPI.

A variety of federal programs, including grants and interest-free loans, could help small practices make the move to electronic, Johnson said.

At least $100 million will be needed the first year to spark nationwide change, she said, but the money could be raised from state funds and the private sector, in addition to the federal government.

Johnson sponsored the 2005 bill that stalled last session in the House but said she thinks the political climate has changed enough to get a similar bill through this year.

"I think this year because of all the work we did last year, the ideas are more mature (and there is) understanding of the (congressional) members of the urgency of getting this installed if you care at all about lowering cost," she said.

One of the roadblocks Johnson's bill ran up against last year was concern over privacy invasion if medical records were uploaded onto a nationwide system. However, a project conducted by the Agency for Healthcare Research and Quality, scheduled for release this month, may help quell some of these concerns, while highlighting the importance of a continued focus on security.

"I would venture to say that most electronic medical records are a lot more secure than paper records," Jon White, director of health IT for AHRQ, told UPI. "On the other hand, if we don't first attend to privacy and confidentiality, the implementation will be poorly done."