Managed Care - February 2009 - (Page 5) LEGISLATION & REGULATION Stimulus Bill Spurs Plans For Rapid IT Progress A new administration, new funding, and new commitment might help the system realize a long-sought goal By John Carroll ver the past few years, hopes for rapid progress in spreading information technology throughout the health care system have been stymied as most small and medium-size physician practices remained on the sidelines. The hefty investment in time and money required to digitize records at a practice repeatedly trumped promises of greater efficiency. Now, though, the declaration of the new president that he is intent on using technology to rein in health care costs and improve quality and an offer to back it up with billions of dollars in the economic stimulus bill has spurred expectations to new heights. Even some of the most hardened observers believe that the industry could be just a few short years away from passing a major tipping point for adopting electronic health record technology. “We’re adding a turbocharger,” says Mark Leavitt, MD, chairman of the Certification Commission for Healthcare Information Technology (CCHIT), who outlined a series of new certification goals. “We don’t know the details, but we expect there will be a component of the stimulus bill directed at health information technology.” New federal money to subsidize the adoption of health information technology — penciled into the stimulus bill by Democrats in the House at $21 billion and in the Senate at $23 billion — could go a long way to winning over reluctant doctors, says Douglas Henley, MD, the executive vice president of the American Academy of Family Physicians. “Speaking of our members, I think you would see it go from a 40 percent adoption rate for electronic medical records to 60 percent or 70 percent in 18 to 24 months — if it was a significant financial subsidy,” says Henley. O “Delivery systems are structured differently, region to region,” says Charles Kennedy, MD, WellPoint’s vice president for health IT. One market analyst recently estimated that Congress could eventually approve as much as $75 billion to $100 billion to push the use of electronic medical records (EMRs) toward President Obama’s ambitious — and some say largely unrealistic — goal to get every American’s health record into an EMR in only five years. However, whatever actual money Congress ultimately allots for the task, the activity in Washington has already revved up expectations. There’s already been a considerable amount of foundational work done, says Charles Kennedy, MD, WellPoint’s vice president for health information technology, pointing to CCHIT’s work on technical standards. Now, he adds, we’re down to “the last mile: creating the local and regional infrastructure to allow data sharing and getting actual applications into the physician’s office.” The stimulus package can move that whole process forward. The numbers for doctors remain daunting. A new EMR system can cost from $20,000 to $30,000 per doctor in a practice. The amount of time it takes to master and maintain the technology translates into fewer patients seen and less revenue. RHIO component “The big hole is the RHIO [regional health information organization] component,” Kennedy adds, which WellPoint has supported with millions of dollars. “That’s an area that’s still extremely challenged in showing proof of deployment, proof of value to physicians, and proof of value to health plans. RHIOs need to evolve, either into a health bank entity or what we call a custodial entity. Health plans could provide a health bank function, or a hospital plus a Microsoft HealthVault or Google Health bank could provide that role.” Congress’s plans make CCHIT want to redouble its effort to improve interoperability, security, and quality, says Mark Leavitt, MD. FEBRUARY 2009 / MANAGED CARE 5
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