Improved Health System Needs Electronic Base, Says Thompson

The strategic outline for implementing electronic health records (EHRs) within the next decade for nearly all Americans was released at last month's Secretarial Summit on Health Information Technology (HIT) in Washington, D.C.

Tommy Thompson, secretary of Health and Human Services (HHS), announced“ The Decade of Health Information Technology” to accelerate national progress in adopting health information technology.

“The health care sector needs to run, not walk, toward realizing the potential for improving our health care system,” Thompson said in an HHS press release.

APA was invited to participate in the summit by Thompson and was represented by Nancy Trenti, an associate director in the Department of Government Relations. APA plans to meet with David Brailer, M.D., Ph.D., national HIT coordinator, in the fall to discuss safeguards for privacy in electronic health records, Trenti told Psychiatric News.

The benefits of adopting an EHR system include improved quality and safety of health care, better use of resources and cost savings, and increased practice of evidence-based medicine, according to the strategic plan.

“Health records should follow the patient, and clinicians should have access to critical health information when treatment decisions are being made,” said Brailer at the summit.

He prepared the report, titled “The Decade of Health Information Technology: Delivering Consumer-centric and Information-Rich Health Care,” that Thompson presented at the summit. It will be used to guide publicand private-sector efforts to implement HIT.

President Bush issued an executive order in April calling for a national EHR system to be established within a decade and the creation of Brailer's position within HHS (Psychiatric News, June 4).

The AMA said in a press release that it “welcomed the strategic report and is committed to helping fulfill the promise of an affordable, standards-based, electronic health record.”

There is bipartisan support in Congress for establishing a national HIT system. Rep. Patrick Kennedy (D-R.I.) introduced comprehensive HIT legislation last month in the House of Representatives (Original article: see story below).

Incentivizing Physicians

Only about 20 percent of physicians and 13 percent of hospitals reported in 2002 that they have adopted EHR systems, according to Brailer.

The biggest barriers to HIT adoption among doctors are the high costs—more than $30,000 per doctor—as well as staff time to transition to EHRs and the lack of standards for exchanging information among different systems, according to a press release from the American College of Physicians (ACP).

ACP has proposed that the government provide financial assistance to physicians to implement EHRs including grants, tax credits, and low-interest rate loans.

HHS will consider several financial incentives including reimbursing clinicians for using EHRs consistent with current Medicare law and paying clinicians for delivering the best quality of care rather than the highest volume of care, said Brailer.

To better understand the value of these options from a societal and industry perspective, Thompson appointed a Health Information Technology Leadership Panel. The group must present its findings to Thompson by October, according to Brailer's report.

Securing Private Information

Ensuring that private health information is protected and accessible only to authorized people is another key element of Brailer's plan. The national HIT system must comply with federal standards for privacy and security mandated by the 1996 Health Insurance Portability and Accountability Act (HIPAA), Brailer stated in the report.

HHS adopted the final security standards last year to protect patient identification when health information is transmitted electronically.

The Department of Veterans Affairs (VA) has developed a HIPAA-compatible EHR system known as the VistA-Office Electronic Health Record, now used at more than 1,300 VA facilities in the United States. The VA plans to make a software version available to the private sector in late 2005.

Private HIT groups last month volunteered to develop the criteria to certify that an EHR system is functional and secure and can exchange data with other electronic health data systems, according to HHS.

In related news, HHS will publish a proposed regulation this year on standards to facilitate electronic prescribing as mandated by last year's Medicare law (Psychiatric News, May 21). A House subcommittee on health recommended to HHS officials last month that e-prescribing records should be designed to be compatible with future EHR systems, according to the July 23 CongressDaily.

A summary of “The Decade of Health Information Technology: Delivering Consumer-centric and Information-Rich Health Care” and fact sheet are posted online at<www.hhs.gov/news/press/2004pres/20040721.html>.▪