Suddenly, EHR is the talk of D.C.

By Jack Beaudoin
12:00 AM

With three of the most influential politicians in the United States calling for improvements to the nation's healthcare IT infrastructure in January, industry insiders believe the time for an electronic health record may be at hand.

The most significant urging came from President George W. Bush, who used his annual State of the Union address to lobby Congress for upgrades in healthcare information technology. "By computerizing health records," he said, "we can avoid dangerous medical mistakes, reduce costs, and improve care."

While Bush's comment and subsequent remarks in a weekly radio address to the nation eclipsed calls from Sen. Ted Kennedy (D-Mass.) and Sen. Hillary Rodham Clinton (D-N.Y.), the confluence of attitudes on both sides of the political divide bodes well for progress.

In fact, the Democratic Leadership Council called "Health Information is Good Medicine" its "Idea for the Week." On its Web site, the DLC credited Sen. Clinton with beating Bush to the IT punch by two weeks, citing her Jan. 12 speech at Cornell University's Weill Medical College:

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"Despite the enormous financial and human costs of poor health quality data, the U.S. healthcare sector has been slow to adopt available information technology, Clinton noted. 'Average information technology spending per employee among all U.S. industries is nearly $7,000 per year. The banking sector alone spends almost $15,000 per employee. Yet healthcare invests only $3,000 per employee per year on IT,' she said."

Clinton went on to call for an increase in quality-of-care re-search, provider report cards and electronic health records, a national information technology infrastructure, point-of-care information technology to both patients and physicians and finally, a pay-for-performance program that will "incentivize and reward" high quality care.

All of this attention has the industry abuzz.

"It's tremendous for the industry," said Dan Michelson, senior vice president at Allscripts. "For a long time, people kept waiting for that 'one thing' to happen that would boost adoption. Now they're recognizing that it'll take more than just 'one thing'."

Michelson predicted that the political focus could have two outcomes - it will either increase reimbursements for providers using an EMR or lead to federal grants to help establish widespread use of healthcare information technology. "A state of the union address is essentially a first draft of the next budget," he said.

Others agree the president's words could signal a change in reimbursement that they feel is long overdue.

"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."

About 60 million Americans, in fact. Winchester said that public awareness could have three immediate effects: "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. "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, agreed with that point. He noted 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."

Physician practice consultant Bob Dichter, president of Optimal Practice Solutions in Sharon, Mass., said he prefers private action to government fiat in this case. "Physician practices and hospitals should move to adopt EMRs," he agreed, "but it depends on what the government plans to do to influence that decision."

Meanwhile, organizations are hailing the month as a major milestone in the effort to implement an electronic health record.

H. Stephen Lieber, president and CEO of Healthcare Infor-mation and Management Systems Society (HIMSS), called it a momentous occasion. In a letter, 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."

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