Bush Administration Report Recommends Implementation of EMRs, Other Health Care IT

HHS Secretary Tommy Thompson on Wednesday is expected to release a report that will detail the "broad outlines" of the Bush administration's long-term plan to establish a nationwide system of electronic medical records and to encourage hospitals and clinics to invest in information technology, possibly through grants or low-interest loans, USA Today reports (Schmit/Appleby, USA Today, 7/21). Thompson plans to present the report -- titled "The Decade of Health Information Technology" and prepared by recently appointed National Coordinator for Health Information Technology David Brailer -- at the beginning of a government-sponsored conference that will include 1,500 IT and health care industry representatives (Lohr, New York Times, 7/21). President Bush in May proposed establishing a national EMR system within the next decade. Thompson at a May HHS health IT summit said that establishing an EMR system could save the United States at least $140 billion per year (Kaiser Daily Health Policy Report, 5/28). Thompson in May also announced the creation of the Office of the National Coordinator for Health Information Technology as part of Bush's proposal to establish the national EMR system. Bush had issued an executive order to create such an office within HHS. The office coordinates and evaluates current and future department IT efforts and will establish technical standards to allow physicians and hospitals to share EMRs and ensure patient privacy. Bush has said that Brailer will establish the technical standards by the end of the year (Kaiser Daily Health Policy Report, 5/7).

Financial, Safety Outlines

The Bush administration set aside $50 million for EMR projects in 2004 and included $100 million for such projects in its 2005 budget. The report states that the government will seek to resolve "a previous lack of cohesive federal policies supporting" health care IT by setting goals for health providers and working closely with the private sector to establish safety and privacy standards to reduce the financial risks of a fragmented industry. According to the report, the government plans to form a Health Information Technology Leadership Panel of industry officials and health care experts to explore the costs and benefits of health care IT and ways for the government to accelerate adoption -- 13% of hospitals and 14% to 28% of doctors' offices currently have an EMR system in place (New York Times, 7/21). While the plan is "short on specifics," it states that the government is considering the use of regional grants and low-interest loans, USA Today reports. EMR systems can cost doctors about $10,000 annually (USA Today, 7/21). According to the Wall Street Journal, installing an EMR system in a large hospital can cost about $20 million (Wysocki, Wall Street Journal, 7/21).

Medicare Internet Portal

The Bush administration is also planning to fund a variety of pilot projects that will encourage technological transparency and advancements. The first such pilot program, which will be announced in the report, is an online portal for Medicare patients in Indiana to access billing information online. The portal, set to be launched in the fall, will allow Medicare recipients to locate information on their medical claims, dates and procedures. The program will eventually also include individualized information about preventive care options for each patient. CMS already tracks health records through billing codes, but Thompson said on Tuesday that the portal will translate the information into "language you're going to be able to understand" (Neergaard, AP/Las Vegas Sun, 7/20).

Democratic Plans

Presumptive Democratic presidential nominee Sen. John Kerry (Mass.) has joined Bush in "campaign[ing] vigorously in favor" of health care IT investment, the Journal reports. Kerry has proposed a "technology bonus" to insurers and providers to update their methods and implement EMR systems. Kerry said that the program could save "billions of dollars," noting that the Veterans Administration has cut the cost of retrieving a medical record from $9 to practically nothing (Wall Street Journal, 7/21).

Reaction

Computerizing medicine is "one of the most important things we can do to improve the quality of health and at the same time make the cost of health care more affordable," Thompson said (AP/Las Vegas Sun, 7/20). Thompson added he expects hospitals and doctors offices to adopt EMR systems "[i]n the next couple of years." However, some health care analysts said that more concrete plans are needed before they could speed up health IT progress. Sam Karp of the California HealthCare Foundation said, "You don't change a cottage industry overnight" (USA Today, 7/21). Experts say "much will depend on how forcefully the government pursues its goals and how effectively the private sector responds," the Times reports (New York Times, 7/21). Trace Devanny, president of health care IT supplier Cerner, said, "The lack of standards is a huge contributor to the friction we encounter every day in the marketplace" (Wall Street Journal, 7/21). However, Thompson said once standards are in place, the government will "demand that the medical industry invest in technology." Neal de Crescenzo, head of the health care practice for IBM's business consulting service, said, "You need the big stick of the government and the innovation and commitment of the private sector." He added, "[T]he real test will be 6, 12 or 18 months down the road. Are the standards being set and implemented, and are these networks being built?" (New York Times, 7/21). An HHS press release detailing the report is available online.

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