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Frist, Clinton Pledge Health Care IT Push

JUNE 16, 2005 -- Sens. Bill Frist, R-Tenn., and Hillary Rodham Clinton, D-N.Y., both potential presidential candidates for 2008, joined forces Thursday to introduce legislation to create a nationwide electronic medical record system they said would improve the quality of care and save billions in health care costs.

The Frist–Clinton alliance, along with ongoing efforts by the Department of Health and Human Services to create electronic standards that would allow health information technology systems to share information, plus a call from President Bush for most Americans to have electronic medical records within the next decade, have raised hopes that "Health IT" legislation will move this year.
Frist said Thursday he hoped to pass legislation within the next 18 months. He also said he would work with sponsors of other health IT bills to see if they could combine their measures in order to speed the legislative process. A handful of measures, such as one sponsored by Sens. Debbie Stabenow, D-Mich., and Olympia J. Snowe, R-Maine, have been introduced to speed the use of health care information technology. Frist also said he was discussing the issue with House GOP leaders.

Frist and Clinton unveiled their bill during a news conference staged at the admissions waiting area of George Washington University Hospital, a facility that has its own internal electronic medical record system where physicians can access information about patient allergies, test results, and other items that could mean the difference between life or death in a medical emergency.

"We're ahead of most hospitals," said Dr. Richard Becker, the hospital's chief executive officer.

But without "interoperability," the ability to transfer that information electronically between systems and across the country, the true promise of health care technology will never be realized, the senators said.

"With all of this advanced care, we are still one of the most fragmented systems in the world," said Frist, who is also a physician. "We're in the stone age. We're not in the information age."

Frist called Clinton his "partner in this endeavor," an alliance that he admitted "surprises some people." The senators said the idea was hashed out over a working dinner the lawmakers shared with other Senate colleagues a few years ago. Frist and Clinton collaborated on an op-ed piece about health IT published in the Washington Post last summer and said Thursday that they plan to work aggressively to move their legislation through the Senate as soon as possible.

Clinton said the bill would help "improve quality and reduce costs in our wasteful, inefficient system" that spends more on health care than any other nation in the world.

Among its provisions, the measure would codify the Office of National Coordination for Information Technology, an office within HHS now working to develop interoperability standards. The measure would also provide exemptions from existing federal laws to allow hospitals, health plans, and others to provide health information technology equipment to physicians as long as the purpose was to reduce medical errors, improve quality, and reduce costs, among other goals. The bill would authorize $125 million annually for five years for grants to local or regional collaborations of hospitals, health plans, doctors, and other providers to develop health information technology standards.

While the standards would be mandatory for federal government programs such as Medicare and Medicaid, they would be voluntary for the private sector.

The Frist–Clinton bill would also direct the HHS secretary to establish a "value-based purchasing pilot program" under Medicare to encourage the reporting of health care quality data and facilitate the payment of providers based on performance. After two years, the HHS secretary could expand that program and implement it nationwide.

Pay-for-performance, or "P4P," pays a doctor or hospital more for higher scores on specific measures of performance. Federal officials and policy wonks are touting pay-for-performance as a way to improve medical care for Medicare beneficiaries and spend federal health care dollars efficiently. While many provider groups have embraced the idea, some fear such policies may reduce their federal reimbursement for services.

More than 20 organizations, including manufacturers, health groups, unions, and trade associations, have endorsed the Frist–Clinton bill and Frist said he expects more to join on board in the days ahead. HHS Secretary Michael O. Leavitt said in a statement Thursday that he welcomed the measure and looks forward to working with Frist and Clinton "and with people around the country, to make electronic medical records secure accessible and portable for everyone."

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