By Jack Beaudoin, editor
The push for an electronic health record received a major boost Tuesday when President George W. Bush identified a computerized patient record as part of the cure for the nation's healthcare woes.
Bush's views on the need for 21st century healthcare technology came in what's considered his most important political speech of the year – the nationally televised State of the Union Address before a joint session of Congress. Analysts say an estimated 60 million Americans tuned into the primetime address on Jan. 20.
Bush's healthcare IT remark was brief but to the point: "By computerizing health records,," he said, "we can avoid dangerous medical mistakes, reduce costs, and improve care."
It may not have been a clarion call for action, but even the merest mention of the issue should help drive adoption of EMRs in physician practices and advance the cause of a national standards-based EHR in the next year, industry experts say.
"It's tremendous for the industry," said Dan Michelson, senior vice president at Allscripts. "For a long time, people kept waiting for that 'onething' to happen that would boost adoption. Now they're recognizing thatit'll take more than just 'one thing' and the president's remarks willcertainly help.
Michelson said he expects that as a result of the speech, "reimbursements(for providers using an EMR) are going to change or there will be grants. Astate of the union address is essentially a first draft of the next budget.
"My ears definitely perked up," said Marc Winchester, senior vice president of market development for Misys. "His making this statement means that the issue is suddenly brought into the living rooms of most Americans.
H. Stephen Lieber, president and CEO of Healthcare Information and Management Systems Society (HIMSS), called it a momentous occasion. In a letter to members Lieber and HIMSS Chairman David E. Garets noted that this is "the first time a president of the United States has addressed the need for improving the quality of healthcare through the effective utilization of information and management systems. This remark … substantially elevates the level of awareness and importance to an issue our industry has grappled with for more than two decades."
Such awareness, Winchester says, will have a threefold effect. "First, it lends legitimacy to what most EMR vendors have been saying," he noted. "Second, I think patients may start asking their doctors about how they're keeping records. When they begin asking these questions, adoption rates should increase because doctors who don't use an EMR will be at a competitive disadvantage."
"Finally, it puts pressure on insurers to alter their rate structures," Winchester said. "Healthcare is the only industry around where good providers get paid the same rates as bad providers. Insurers will have a vested interest in working with doctors to prove they're good, and that will require computerized records."
Mark Anderson, CEO of the AC Group, said speeches are one thing, but the administration will prove it means business on healthcare IT only if it takes some credible actions. "IOM and administration task forces have been talking about this for years, but they're talking about building a perfect system," he says. "That's 10 years out. There're a lot of things they could be doing right now to improve adoption rates."
Anderson said that if malpractice insurers heeded Bush's words and didn't offer coverage to practices without an EMR, adoption would skyrocket. "And if Medicare said you needed outcome data, everybody would go out and get one… It needs a financial incentive – and when that happens, it will explode."
Of course, there's a downside as well, says Robert Dichter, president of Optimal Practice Solutions in Sharon, Mass. "Physician practices and hospitals should move to adopt EMRs," he agrees, "but it depends on what the government plans to do to influence that decision."
Dichter agreed with Winchester that incentives from payers – whether insurers or the federal government – is a better approach than applying sanctions for failing to adopt EMRs. "The key is to incentivize with better rates, and providing discounts for implementation," he said.
