Bush Administration Releases Details of Long-Term Health Care Information Technology Strategy

As expected, HHS Secretary Tommy Thompson on Wednesday presented a report outlining the Bush administration's long-term health care information technology strategy that he said will "provide a quantum leap in patient power, doctor power and effective health care," the Minneapolis Star Tribune reports (Phelps, Minneapolis Star Tribune 7/22). The plan will establish a nationwide system of electronic medical records and encourage health care providers to invest in information technology, possibly through government incentives such as regional contracts, grants and low-interest loans (Reuters/Boston Globe, 7/22).

Thompson presented the report -- titled "The Decade of Health Information Technology" and prepared by recently appointed National Coordinator for Health Information Technology David Brailer -- at a government-sponsored conference attended by more than 1,000 health IT professionals. President Bush in May proposed establishing a national EMR system within the next decade.

Thompson at a recent HHS health IT summit said that establishing an EMR system could save the United States at least $140 billion each year. In May, Thompson 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 (California Healthline, 7/21). Sen. Judd Gregg (R-N.H.), chair of the Health, Education, Labor and Pensions Committee, said he plans to introduce a bill on Thursday that will follow up on the HHS report (Rovner, CongressDaily, 7/21).

The Bush administration set aside $50 million for EMR projects in 2004 and included $100 million for such projects in its 2005 budget (California Healthline, 7/21). According to Brailer, the report was prepared to describe goals for health providers and start a dialogue on health IT between the private and public sectors (CongressDaily, 7/21). The report also noted the importance of establishing safety and privacy standards.

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. EMR systems can cost doctors about $10,000 annually, and installing an EMR system in a large hospital can cost about $20 million (California Healthline, 7/21).

While CMS plans to press doctors to begin writing more prescriptions electronically, the practice will remain optional, CMS Administrator Mark McClellan said. "Promoting the adoption of e-prescribing is an essential step toward improving the safety and quality of health care," McClellan said (Reuters/Boston Globe, 7/22). He added that CMS later this year will release regulations to implement standards for e-prescribing (CongressDaily, 7/21).

The Bush administration is also planning to fund a variety of pilot projects that will encourage technological transparency and advancements. The report listed nine communities that have been awarded a total of $2 million to begin pilot projects through an agreement between the government and the Foundation for eHealth Initiative. The federal government is expected to award an additional $60 million in grants by the end of the year, USA Today reports (USA Today, 7/22).

The "first step" in advancing health IT is CMS' introduction of an online portal for Medicare patients to access billing information online, Reuters/Globe reports (Reuters/Boston Globe, 7/22). 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 has said that the portal will translate the information into "language you're going to be able to understand" (California Healthline, 7/22).

According to Thompson, "This plan sorts out the myriad of issues involved in achieving the benefits of health information technology, and it lays out a coherent direction for reaching our goals" (Reuters/Boston Globe, 7/22). Thompson added, "It's time for health care to catch up" (USA Today, 7/22).

The American Medical Association said it supports the plan, which has already "spawned a small industry of companies" interested in offering EMR systems, Reuters/Globe reports (Reuters/Boston Globe, 7/22). George Isham, chief medical officer for Minnesota-based HealthPartners said the plan "certainly is needed," although he noted that the 10-year time frame is "awfully ambitious." Isham added that the plan will be expensive and labor-intensive, but "[t]his is all very exciting" (Minneapolis Star Tribune, 7/22).