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Health technology may get massive investment, though concerns persist

Posted by Lisa Wangsness, Political Reporter January 12, 2009 05:01 PM

The Obama transition team and Congressional Democrats plan to invest tens of billions on health information technology in the economic stimulus plan now being fashioned on Capitol Hill, even as a growing number of specialists raise concerns about the ability of existing electronic records systems to share information and help doctors treat patients.

Helen Darling, president of the National Business Group on Health -- a voice for large corporations on healthcare issues -- told reporters in a lunchtime briefing today that at this point, those involved in crafting the legislation plan to include $25 billion to $50 billion for health information technology.

In a report last week, the National Research Council identified grave shortcomings in existing health information technology software. The council said medical software is unnecessarily complicated to use -- far more difficult than conventional office software -- and it focuses on accumulating small bits of patient data rather than interpreting that information to help doctors take care of patients in a more sophisticated and effective way. Implementing the technology before it is substantially improved, the report said, could actually hinder progress toward a top quality wired system.

Other health technology experts, including a leading technology adviser to the American Academy of Family Physicians, have also warned the Obama transition team that different brands of electronic medical records do not mesh well, despite government standards that are supposed to guarantee easy exchange of information. Two doctors in the same town often cannot exchange full patient records easily, even if their offices are wired.

Darling said she strongly believes Congress must get tougher on the industry, which she said could move far more quickly if forced to do so.

"We are in a war for the recovery of the United States economy," she said. "We should have the same attitude towards all these things we would have in war, which is, we don't have time..... Getting some of these problems resolved is more important than anyone's narrow interest."

She also said that those working on the health stimulus legislation hope to include $1 billion for comparative effectiveness research, which seeks to advise doctors on the best course of treatment for sick patients based on all available scientific research.

They also plan, she said, to subsidize at least half of COBRA insurance premiums for the unemployed, who must now pay the entire cost of their health care -- more than $12,000 a year for the average family -- if they wish to keep the insurance they had at their former job.

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An Inherent Conflict of Interest within CCHIT

Under the Federal Government's direction, CCHIT has been given the task of promoting IT (information technology) within the health care industry. Approximately half of CCHIT's Board of Directors work for medical insurance companies, commercial medical informatic companies, physicians employed by very large group practices or EMR companies. As a result, CCHIT's priorities have been tailored to reflect the interests of it's Board of Directors, rather than the needs of the physicians and the health interests of our society at large.

CCHIT is now attempting to coerce physicians to purchase specific, expensive and "CCHIT certified" electronic medical record programs, which are designed to collect medical information. This information is "quantified;" thereby creating a hugh repository of all US healthcare interactions. As 16% of the US GDP is spent on healthcare, the amount of information that will be stored in these databases is massive and will eventually be available (for sale) to third parties. One can logically conclude that those organizations who have access to this information will be able to exert a hugh influence on the future of US healthcare.

There are now several hundred non-CCHIT certified EMRs on the market which provide low cost and innovative solutions that are not otherwise available to physicians. If CCHIT's influence remains unchecked, many small EMR companies will be forced out of business. The end result will be extremely disruptive to small medical practices, while forcing them to adopt expensive and bloated software while creating a frighteningly comprehensive healthcare database.

As a practicing physician who also has more than 15 years experience incorporating IT into small medical practice, I am in a unique position to understand the needs of the healthcare community and the potential of health IT. I am a firm believer that the appropriate use of health IT can improve the quality of healthcare. However, it is my opinion that the Federal Government needs to force the Certification Commission for Health Information Technology to alter their priorities so that they mirror the needs of the the majority of the medical community, rather than the interests of CCHIT's Board of Directors and their representative companies. This can only be accomplished by replacing CCHIT's Board of Directors, who have a financial interest in the health information technology industry, with people who have no financial connection to the medical-health IT-pharmaceutical industrial complex.

In President Eisenhower's Farewell Address, he said "...we must guard against the acquisition of unwarranted influence ... by the military-industrial complex... Only an alert and knowledgeable citizenry can compel the proper meshing of the huge industrial and military machinery ... so that ... liberty may prosper ..." The size of US's medical-health IT-pharmaceutical industrial complex now rivals the size of it's military-industrial complex and the parallel between the two industries is too obvious to be discounted. If we choose to ignore this historical precedent, then the future of healthcare in the USA will be controlled by several powerful industries, whose priorities do not necessarily parallel the health interests of our society. And once these industries take control of the health industry, their political influence will ensure that they will remain in control for many decades into the future.

Hayward Zwerling, M.D., FACP, FACE
President
ComChart Medical Software
www.comchart.com
www.DiabetesEndocrine.com

Posted by Hayward Zwerling, M.D January 13, 09 07:54 AM
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Current "health IT" systems work no way as well as computer software consumers are used to using, such as Microsoft Office, I-Tunes, etc. Health IT is where wordprocessing was 15 years ago. There certainly needs to be an investment in health IT, but this should come from the companies who need to improve and develop products. Government investment in currently available software would be a waste of resources.

Posted by mrappap206 January 13, 09 08:27 AM
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The VA medical care system (which trains the largest number of US health care providers annually) has HAD a HIGHLY successful electronic medical record system (with billing capabilities) for years. Why reinvent the wheel at massive tax payers expense? We have already paid for this system. This allows for electronic notes, medication administration, lab values, radiology exams medication dispening information, dryg-drug and drug-disease interactions, etc to be seen/used. This system also allows for monitoring of information nationnaly on a real time basis. Nothing needs to be built nor billions of $ wasted - just have everyone use this system that has ALREADY had the "bugs worked out". Stop wasting tax dollars and use what we already have (and many medical personnel have already used/were trained upon).

Posted by spend health dollars wisely January 13, 09 05:21 PM
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