Lawmakers: Medicare's cost crisis starving health IT

By John Pulley
01:00 AM
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The prognosis is simple for a health care system that is hemorrhaging money: Submit to rehabilitation in the form of widespread adoption of information technology or stand by as the condition worsens.

That was the overall message delivered June 21 at the Capitol Hill Health Information Technology Showcase in Washington.

"We are headed for the cliff," said Sen. Kent Conrad, (D-N.D.). He cited projections that, without meaningful intervention, expenditures on Medicare and Medicaid could rise to 20 percent of the gross domestic product over coming decades.

Sen. Sheldon Whitehouse (D-R.I.), said failure to fix the systems guarantees that Congress "will be forced to make savage cuts" later.

However, implementing necessary IT solutions amounts to major surgery. Among the challenges are an absence of interoperability among different health IT applications, a lack of universal broadband access, insufficient political will at the national level and misalignment of the financial incentives needed to propel rapid adoption of health IT.

Another challenge is the dealing with the issue of privacy. Consumers' concerns about the confidentiality of health information, if not addressed, could hamper widespread adoption of electronic medical records and other IT solutions.

The public's concerns aren't misplaced, said Rep. Patrick Kennedy (D-R.I.), who predicted that failure to secure patients' electronic records would invite misuse of the data by life insurance companies, big pharmaceutical companies and other corporate interests.

"To move forward with IT, it needs to have as its cornerstone privacy," Kennedy said.

The cost of deploying new technology is another challenge because Congress has been slow to appropriate funds for deploying health IT.

"The real issue here is to"¦try to move the ball forward in a Congress that doesn't want to make any down payments [on IT]," Kennedy said.. "Everybody's squawking about how much it will cost to implement. "¦.Put it in context of how much we'll get back."

Several lawmakers cited a report by RAND Corp. that projected savings of $80 billion annually with widespread adoption of health IT. "If we invest now, we recoup savings and are able to provide more health care," Kennedy said. "What's the morality of waiting?"

Federal Communications Commission Commissioner Deborah Taylor Tate said the commission is "committed to providing the framework" to enhance telemedicine. "One day, every health care facility will be connected through broadband," Tate said.

Karen Bell, director of the Department of Health and Human Services' Office of Health IT Adoption, said a working group there is addressing ways of promoting remote care. Among the hurdles to be overcome are laws and regulations that preclude reimbursement to health care providers that deliver services remotely; statutes that prohibit doctors from caring for patients in states where they are not licensed; an absence of policies that ensure the privacy and security of medical records and technological issues, such as the lack of interoperability.

Whitehouse suggested that an independent organization fashioned on the model of COMSAT, founded in the early 1960s to promote the satellite communication industry, could cut through the confusion and speed up adoption of health IT.

However, one industry representative was cool to that idea, noting that the Electronic Health Record Vendors Association has taken action to promote interoperability among health IT applications.