Article published February 15, 2008
By: Matthew DoBias / HITS staff writer
Adams
A leading health information technology advocate said Thursday that government initiatives to advance electronic health records, e-prescribing and other technologies are doomed to fail because the effort is too spread out and not focused on individual providers.
“Achieving the significant and sustained improvement we need in healthcare requires the testing of multiple concepts in the field simultaneously,” Laura Adams, president and chief executive of the Rhode Island Quality Institute, told members of the Senate Budget Committee. “We believe that health IT adoption, work on quality improvement and prevention and reforming the toxic payment system must be tested in aggregate in what is an essential yet virtually nonexistent research and development role for healthcare.”
But Adams said that the needed ground-level testing is greatly hindered by a lack of funding, support and by competing interests who eye only their own bottom lines rather than the overall goal. “As a result, we’re learning at an achingly slow pace as a nation,” she said. “After literally years and years of toil, we have come nowhere near what the architects of these initiatives had envisioned.” Adams’ comments echo the findings of a government report released on Thursday that found that despite some advances, HHS “has not yet completed a national strategy for” health IT and that the department’s reluctance to do so has stalled industry momentum.
“Given the amount of work yet to be done and the complex task of integrating the outcomes of HHS’ various initiatives, it is essential that a national strategy for health IT be defined that includes plans, milestones and performance measures for ensuring progress toward the president’s goals,” said Valerie Melvin, director of human capital and management information systems issues at the Government Accountability Office.
The Budget Committee hearing comes four years after President Bush called for the widespread adoption of integrated health records within a decade and strongly hints that the U.S. healthcare system is a long way from reaching that deadline. Studies show that at best, only about 20% of doctors' offices across the country have adopted some version of electronic medical records—and the majority of those systems don’t link up with other systems even within the same networks.
Melvin said that the GAO expects even slower going in the future unless HHS develops and adheres to a workable national strategy that would sort out what works and what doesn’t. “Without such a strategy, it is difficult to effectively monitor progress toward achieving national goals for health IT,” she said.
Mary Grealy, president of the Healthcare Leadership Council, said that the upfront costs of health IT often prevent providers from making the jump from paper to computers. “In an age in which healthcare providers must deal with rising costs associated with uncompensated care, medical liability rates, public health disaster preparedness and addressing staffing shortages, it is a simple fact that many providers do not have the financial wherewithal to invest in these new systems,” she said.
Sen. Judd Gregg (R-N.H.) said at the hearing that health IT legislation that offers some federal help but that has stalled on Capitol Hill could move forward sometime this year. Gregg said that hospitals in his home state have also asked for financial relief from the federal government—largely to help defray the costs of implementation and interoperability.
“The problem as I see it is that we all say we want interoperability, but it’s really a huge issue to get it,” Gregg said.
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LINK: http://modernhealthcare.com/apps/pbcs.dll/article?AID=/20080215/REG/476798157
