Popovits & Robinson - Client Advisories

April 2004 - PRESIDENT BUSH UNVEILS MAJOR HEALTHCARE IT INITIATIVES

President Bush recently unveiled several major healthcare technology initiatives that he believes will help transform health care in America by improving health care quality, reducing health care costs, preventing medical errors, improving administrative efficiencies, reducing paperwork, and increasing access to affordable health care.

In a recent speech, the President discussed the rationale for an increased focus on health information technology. Noting that the U.S. health care system has a long and distinguished history of innovation, the President also noted that the health care system faces major challenges. Health care spending and health insurance costs continue to skyrocket, and there remain serious concerns about preventable errors, uneven health care quality, and poor communication among doctors, hospitals, and many other health care providers involved in the care of any one person.

The President stated his belief that many of the problems associated with health care are related to the failure to use health information technology as an integral part of medical care. He noted that medicine still operates primarily in an outdated, paper-based system. The specific problems discussed by the President include the following:

A patient's vital medical information is scattered across different caregivers in different locations, and all of a patient’s medical information is often unavailable at the time of care. For example, patients with medical emergencies are often seen by doctors with no access to information about allergies or current medications.
Medical orders and prescriptions are handwritten and often misunderstood or not followed in accordance with the physician’s instructions.
Consumers lack access to useful, credible health information about treatment alternatives, which hospitals and physicians are best for their needs, or their own health status.

These and other conditions set the stage for preventable medical errors.

The initiatives announced by the President are intended to encourage public and private sector efforts to adopt health information technologies, with the overarching goal of ensuring that most Americans have electronic health records within 10 years. The President predicts that electronic health records will ensure that complete health care information is available for most Americans at the time and place of care, no matter where it originates. The major initiatives are summarized briefly below.

Adoption of Health Information Standards
President Bush called for the completion and adoption of standards that will allow medical information to be stored and shared electronically. DHHS and private organizations have been working to identify and endorse voluntary standards that are necessary for the safe, secure electronic storage and sharing of information.

Creation of a Comprehensive Medical Vocabulary
A standardized medical vocabulary developed by the American College of Pathologists was made available for free throughout the U.S. in 2003. The Systematized Nomenclature of Medicine creates a common language that will be an essential component of the creation of a national health information system.

Funding Research Demonstration Projects
President Bush’s proposed FY 2005 budget includes $100 million for research and demonstration projects that will help test the effectiveness of current technology and establish best practices for more widespread adoption.

Creation of a Sub-Cabinet Level Position
The President has created a new sub-cabinet level position within DHHS. On May 6, 2004, David J. Brailer, M.D., Ph.D was appointed to serve as National Health Information Technology Coordinator. The Coordinator will provide leadership and coordination at the national level by:

Guiding ongoing work on health information standards;
Encouraging health information technology in the public and private sectors; and
Coordinating partnerships between government agencies and private sector stakeholders.

Creation of incentives for healthcare providers
The President’s plan calls for the creation of opportunities and incentives for health care providers to use electronic records. Interestingly, President Bush did not mention the Health Insurance Portability and Accountability Act (HIPAA) in his address, and it is unclear how the proposed measures will be reconciled with the principles underlying the Privacy and Security Rules.