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HHS Pushing Speedy Implementation of Health IT

OCTOBER 5, 2005 -- The Department of Health and Human Services announced a series of proposed regulations Wednesday that would speed the use of electronic prescribing and electronic medical records nationwide.

The proposals include creating exceptions to self-referral laws so that hospitals and certain health care organizations can furnish hardware, software, and related training services to physicians for electronic prescribing and electronic medical records.

Vowing to put the traditional medical clipboard and illegible handwritten drug prescription slips "out of business," Health and Human Services Secretary Michael O. Leavitt said the proposals represent a major step toward meeting President Bush's goal that most Americans have an electronic medical record within the next 10 years.

During a news conference at George Washington University Medical Center, Leavitt also announced a proposed "safe harbor" from the HHS Office of Inspector General to allow the donation of technology for electronic prescribing and electronic health records to be exempt from enforcement action under the federal anti-kickback statute.

Proponents of electronic prescribing and medical records say the practices can reduce costs and improve care, but some privacy and consumer groups say they also might compromise patient privacy.

Paul B. Ginsburg, president of the Washington think tank Center for Studying Health System Change, said the proposed changes "may remove a major impediment to development of these information technologies" by unlocking private funds to help speed their use nationwide.

Physicians, especially those in smaller medical groups, often do not have the money to purchase or maintain electronic health care record systems, so allowing hospitals and other organizations to purchase the equipment is a plus, Ginsburg said.

A recent survey from the Medical Group Management Association found that the cost of installing and maintaining electronic records systems is the biggest barrier to their adoption by medical group practices, particularly for the smallest groups. The study found that 14.1 percent of all medical group practices use such a system and 11.5 percent said an electronic health record system was fully implemented for all physicians and at all practice locations.

Physicians are also reluctant to invest in health information technology because they fear that insurers, rather than doctors, will realize most of the savings.

The proposal to allow hospitals to donate hardware, software, and training to physicians would be somewhat narrow until Leavitt establishes and approves nationwide product certification criteria. The Centers for Medicare and Medicaid Services is also considering imposing a cap on the value of the technology that donors can provide, to reduce the potential for arrangements that would pay physicians for referring patients.

The proposed rules were published in the Oct. 5 edition of the Federal Register and public comments will be accepted for 60 days.

HHS also announced that CMS will soon issue a final rule containing the "foundation standards" for e-prescribing that all Medicare prescription drug plans must support. Officials also announced that, as required by the new drug law (PL 108-173), CMS is awarding $6 million to fund "e-prescribing" pilot programs using the foundation standards and additional clinical standards.

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