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Frist Says Feds Should Focus on Health Care IT Interoperability

March 11, 2005—Senate Majority Leader Bill Frist said earlier this week that the government can encourage the health care industry to invest in information technology by keeping a focus on electronic information-sharing standards. Using government resources to promote "interoperability" would do more than distributing federal grants to hospitals, physicians, and other health care providers to install health care IT systems, Frist, R-Tenn., said March 9 after a speech to America's Health Insurance Plans, a trade group representing health care insurers.

"As soon as we do it, you're going to have more people coming under this industry. You're going to see capital flow into it. The need is so huge. It saves lives. The money is waiting to flow in here. It doesn't have to be taxpayers' dollars," he said. While the government may set up some "reserve funds to sort of send the right signal," Frist said, "that's not the fundamental problem. It's not a matter of money."

The role the federal government plays in creating a nationwide health information technology network lies at the heart of the debate over how to improve the use of health care information technology, which analysts say will improve medical care and reduce medical costs.

There is virtually no debate about the value of health care IT. Medical experts and government officials alike praise its potential to cut fraud, waste, and inefficiency from the nation's health care system. Health and Human Services Secretary Michael O. Leavitt has said information technology can transform the federal government's health care programs, such as Medicare and Medicaid, which in turn can lead to major changes in the private sector.

"I believe that the foundation is information technology and a streamlining of the system that we, as federal agencies, need to lead on and create a framework for the rest of the health care system to build upon," Leavitt said March 3 before the House Appropriations Subcommittee on Labor, Health and Human Services and Education. The health care industry has fallen behind other industries that have successfully incorporated information technology to cut costs and improve productivity. Plentiful automatic teller machines and the ability to apply for consumer credit online are just two of the many examples that show how technology has transformed commerce and can do the same for health care.

"American health care has been in the stone age when we should really be in the information age," Frist said, envisioning a future where paramedics can access a patient's medical record at the scene of a traffic accident to check allergies, blood type, and other critical factors.

Dr. David Blumenthal, a primary care physician from Boston, told a House panel last year that health care information technology "has the power to save as many or more lives than antibiotics—indeed, clinical IT has the power to make sure that antibiotics themselves are used more effectively, to save more lives and prevent more suffering."

But there are numerous problems on the road to that goal. Such systems cost money, reduce productivity in the short run, and will not be totally effective until the information they gather is linked to other system across the country.

"Even if every doctor, hospital, and nursing home in the country had the best available computers and software to manage clinical information, it would still be essential to have a means of moving that information from one place to another in a reliable, secure fashion, so that patients and their doctors could take advantage of it wherever they go," said Blumenthal, who is director of the Institute for Health Policy at Massachusetts General Hospital and partners HeathCare System in Boston.

"We need a secure, modern national information superhighway that criss-crosses our country, just as we have a national transportation infrastructure. To get that information highway will require public–private partnerships in which government plays a leadership role," he told the House Energy and Commerce Health Subcommittee in July.

While some larger hospitals and physician groups have invested heavily in health IT and have seen its benefits, many physicians who have their own offices or are in small-group practices have been more reluctant, citing costs and concerns that insurers will use such data as a way to reduce physicians' compensation.

In his remarks, Frist, a physician himself, noted that "too many doctors have been burned...(by) 30,000 dollar off-the-shelf" health care IT systems that they've thrown away a month later because they were too complicated to operate or did not deliver as promised.

"We need to act first" to make such system interoperable, Frist said, "before giving you a $50,000 grant or linking it to payment."

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