Republican hopefuls see health IT as competition lever

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GHIT Notebook

October 22, 2007

The leading Republican presidential candidates are far less explicit about how they would weave health information technology into their overall plans for health care than the Democrats have been, though the broad outline of their vision indicates there will be room for extensive use of IT.

In a recent speech in Iowa to introduce his health care proposals, for example, Sen. John McCain’s only specific reference to health IT was that, as president, he would “promote rapid deployment of 21st century information systems.”

However, other parts of his speech were peppered with references to people receiving quality care rather than just medical services, to the fact that coordination between providers has been shown to produce the best treatment outcomes, and to the greater use of the Web to allow doctors to practice across state lines.

All of these, if they are to be carried through effectively, have been linked to greater use of health IT.

More directly, McCain also talked about developing national standards for measuring and recording treatments and their outcomes and for exploiting telemedicine where appropriate.

Overall, his message was that overall improvement in the health care sector will promote the right environment for technology investment.

“Reform the underlying health care markets and provide an incentive for adoption,” said Dr. Douglas Holtz-Eakin, McCain’s policy director, at a recent Washington policy forum, “then health care IT will be effective.”

Mitt Romney, who headed one of the more ambitious efforts at health care reform when he was governor of Massachusetts, likewise eschewed giving out details on how he would use health IT other than that he would “bring health care into the 21st century by enhancing the use of information technology.”

As mayor of New York City when terrorists drove their planes into the World Trade Center on Sept. 11, 2001, Rudy Giuliani had a close encounter with the use of technology in the aftermath of that attack. Many of the ensuing developments in health IT, particularly its use in disaster response, has come from research into the aftermath of the 9/11 attacks.

In his proposal, Giuliani spoke of the need to invest in health IT to detect health threats and improve efficiency. In particular, he pointed to the fact that thousands of hospital deaths each year are attributed to preventable medical errors.

“Public-private partnerships to improve and set standards for health IT without overbearing regulations can play a major role in improving care and reducing costs,” he said.

As they had with the Democrats and their proposals, observers saw no indication in the Republican proposals about any awareness or understanding of the cultural and social limitations to implementing health IT. But there was enough detail to promote some enthusiasm.

“ I really believe most of the campaigns want to have action on this topic (of health IT),” said Dave Roberts, vice president of government relations at the Healthcare Information and Management Systems Society. “But they are still figuring out how to make it happen.”

Although there is bipartisan agreement on the greater use of health IT in health care reform, some do see a division between the Democratic and Republican approaches based on their vision of government and private sector roles.

“On the left, they talk about (health IT’s) impact on cost and the effect that has on access to health,” said Scott Wallace, president and chief executive of the National Alliance for Health Information Technology. “On the right, it’s more about cost and it’s impact on competitiveness.”

By Brian Robsinson

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