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Healthcare reform is arguably the hot-button political issue of our time. And with the Supreme Court locked and loaded to decide the fate of the Affordable Care Act this summer, it's a safe bet the controversial two-year-old legislation will have a huge impact on the 2012 election and beyond.
But what about health IT? If "Obamacare" has been a lightning rod, sparking historically nasty partisan bickering – Congress vs. President Obama, Republicans vs. Democrats, Fox News vs. MSNBC, the Tea Party vs. MoveOn.org – Washington's efforts to spur healthcare information technology have enjoyed much broader support, on both sides of the aisle.
Just last week, a Washington think tank whose healthcare wing is led by two erstwhile rival Senate Majority Leaders put its weight behind smarter and more widespread use of technology and data exchange in healthcare organizations nationwide.
"To deliver high-quality, cost-effective care, a physician or hospital needs good information," said former senator Bill Frist, MD, upon the release of a report, on Jan. 27, from the Bipartisan Policy Center's Task Force on Delivery System Reform and Health IT. "Data about patients has to flow across primary care physicians, hospitals, labs, and anywhere that patients receive care."
"There is strong bipartisan support for health IT," added Frist's old senate colleague, Tom Daschle, and also for "moving away from a payment model that largely focuses on volume – rewarding providers for doing more – rather than on quality outcomes or value."
Hard to argue with that. But is support for health IT – and the transformative potential to improve quality, lower costs and widen access it represents – really as bipartisan as so many in the industry say it is?
Especially when adoption of electronic health records and establishment of both health information exchanges (HIE) and the highly-contentious health insurance exchanges (HIX) are being spurred in large part by money from the very federal stimulus program against which the Tea Party rose up to protest?
Without question, we find ourselves living in a starkly polarized country.
"When we're up on Capitol Hill, one of the big frustrations is this lack of bipartisanship in general," said Dave Roberts, vice president for government relations at HIMSS. "How do you create bipartisan conversations? Unfortunately, the system has broken down so much that they're not finding a lot of things they can talk about."
Strikingly, however, health information technology is "one of the extremely few areas where there still does appear to be consensus," he said. "I personally think one of the reasons is that you have people on both sides of the aisle who see its value."
How the feds first met HIT
Healthcare got just cursory mentions in President Obama's State of the Union address earlier this month. But in years past, both health reform and health IT have taken much more central roles.
In 2011, for example, Obama touted a new era where "patients will be able to have face-to-face video chats with their doctors," and "Veterans can download their electronic medical records with a click of the mouse."
But Obama's predecessor, so different from him in so many ways (and still reviled by so many of his supporters), has also given the rhetorical nod to health IT – in no fewer than three separate State of the Union addresses.
"We will make wider use of electronic records and other health information technology to help control costs and reduce dangerous medical errors," exhorted George W. Bush in his 2006 speech. These were more than just words, of course: President Bush having established the Office of the National Coordinator for Health Information Technology by executive order in 2004.
Moreover, one of the two remaining Republicans with a plausible chance of succeeding Obama is similarly a fan of health IT. Newt Gingrich, upon the founding of his Center for Health Transformation (CHT) think tank, declared that, "Widespread adoption of interoperable health information technology is a cornerstone of creating a 21st Century Intelligent Health system."
In 2004, Gingrich delivered the keynote talk at the HIMSS annual conference in Orlando, Fla. He also corralled a group of health industry heavyweights to contribute to the CHT book Paper Kills – one of whom, Allscripts CEO Glen Tullman, has told the Wall Street Journal flatly that "healthcare IT is a nonpartisan issue."
We recently asked National Coordinator for Health IT Farzad Mostashari, MD, whether he believes that.
His answer? "Yes."
Even, potentially, with a Republican president and a Republican-controlled House and Senate? Does he think the meaningful use program will go forward, as envisioned when enacted by a Democratic President and Democratic majorities in both chambers?
"That is certainly my hope and belief," Mostashari said.
So the National Coordinator is unconcerned that HITECH Act funding will be affected?
"I don't have a crystal ball, but I see nothing to indicate that there's a real partisan or ideological drive to diminish or roll back the advances we have made on health IT," he said. "This has been for decades a bipartisan issue, and I think people recognize that we've made good progress and that we should keep pushing ahead."
"I've spoken with many members of Congress about the success we're having with healthcare IT," Mostashari said. "What ended up in HITECH was drafted in a bipartisan way. I have not seen anything to indicate there is any partisan rancor around HITECH." He added: "After all, this office (ONC) was founded by President Bush."