WASHINGTON, D.C. -- IT leaders are quickly realizing their role in reforming health care -- creating an electronic health record (EHR) system for tens of millions of soon-to-be insured patients, and giving them access to the information as prescribed by HITECH Act regulations.
In his keynote address to the first AMA-IEE Medical Technology Conference on Personalized Healthcare, Dr. David Blumenthal, national coordinator for health IT, steered clear of connecting the health care reform bill -- signed into law on March 23 by President Barack Obama -- to his own efforts to computerize the nation’s medical records. Blumenthal touched on reforming health care, however, in the Q&A session that followed, when an audience member asked about the role of state governments in helping physicians deploy EHR systems.
States will participate in reforming health care, Blumenthal said, simply by doing what they already do -- licensing health care providers, such as doctors, nurses and pharmacists, as well as facilities. The license is that state’s way of authenticating the sender for parties who receive health information electronically. States also need to collect and share public health data electronically, contributing to such national efforts as containing the H1N1 virus.
The Office of the National Coordinator for Health Information Technology hopes to defray the costs of computerizing all this data with health information exchange (HIE) grants -- costs that just expanded when the Patient Protection and Affordable Care Act reforming health care became law.
Nearly $550 million in grants has been announced in the six weeks, with $386 million in HIE grants awarded to 40 entities on Feb. 12, and an additional $162 million in HIE grants awarded on March 15. (These grants go to states as well as state-designated entities, or SDEs.)
For complete health records and health information … we need the states to be active participants … in the creation of a nationwide, interoperable health system.
Dr. David Blumenthal, National Coordinator for Health IT
“[States] are the custodians of Medicaid data,” Blumenthal said. “For complete health records and health information for the vast -- and shortly to be greatly expanded -- Medicaid population, and for the child health insurance population, we need the states to be active participants … in the creation of a nationwide, interoperable health system.”
The goals of reforming health care and implementing the HITECH Act -- improving patient care and ultimately, patient health -- are admirable, said Dr. Jay Sanders, Johns Hopkins medical professor and president emeritus of the American Telemedicine Association. Nevertheless, he remains pessimistic that those better outcomes will happen until patients themselves have incentives to live healthier lives, because they are more in control of their health outcomes than their doctors are.
Outcomes would be better if insurers could reduce premiums when a patient does not smoke or drink, the way auto insurers reward good drivers with discounts, Sanders suggested. We might be building an electronic health care system, but it is not necessarily more effective than what we have now, he said: “We just bought more bricks, that’s all.”
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