Health-care technology could play role in either administration

October 3, 2008

Both major-party candidates for president have voiced general support for health informatics to help achieve return on investment, reduce medical errors, and improve efficiencies and service quality.

Health information technology (HIT) is meant to expand care providers' ability to reduce paperwork, replace manual documenting processes, and reduce errors in the delivery of patient care through software, hardware, and the necessary infrastructure used to support the collection, storage, and exchange of patient data. The tools include electronic health record systems, e-prescribing systems, practice management systems, and computerized physician order entry systems.

Both Senators John McCain and Barack Obama, the two major party candidates for president, have voiced general support for health informatics to help achieve return on investment, reduce medical errors, and improve efficiencies and service quality, says Sheera Rosenfeld, director of the health information technology practice at Avalere Health LLC, a Washington, DC, consulting firm.

A September 2005 report by the Rand Corp., touted by Obama as part of his health-care platform, estimated that $77 billion annually would be saved if 90 percent of physicians adopted HIT. To date, between 22 percent and 34 percent of physicians in ambulatory settings use an EHR system, according to the AMA.

"There is bipartisan recognition of the value and potential impact of HIT as a core component to improving health-care quality, outcomes, addressing costs, etc.," Rosenfeld says.

However, neither candidate is aware of the innate challenges of HIT adoption and implementation, she maintains. The most pressing matter that many physicians currently face is paying for the up-front costs to make their practices HIT-compatible. In ambulatory settings, particularly in small- and medium-sized practices, physicians face many barriers and continue to have the lowest rates of HIT adoption, says Josie R. Williams, MD, a gastroenterologist and president of the 47,000-member Texas Medical Association.

Rosenfeld says that money is, without question, at the top of the list of HIT concerns. She calls the current set up "misaligned incentives," which require physicians to bear the brunt of up-front costs of HIT innovations, while insurers and other payers reap the savings that the streamlined system is intended to deliver.

Obama has included a $50 billion commitment to establish a health informatics infrastructure in his health-care reform package. McCain hasn't declared how his administration would go about pushing an HIT initiative. Rosenfeld says she will look to the next president to provide more positive traction in moving the idea of health informatics forward.

At the same time, progress is occurring in states in which the next president can take a page. For instance, New York is investing $250 million in a comprehensive health information and quality improvement infrastructure.