The Bush administration doesn’t like several measures in a major health information technology bill under consideration in the Senate, including one that would rely on subsidies rather than market forces to modernize the health care infrastructure.
President Bush had set a target date of 2014 for achieving nationwide use of electronic health records, a goal that administration officials said they had hoped to achieve largely through market incentives.
Health and Human Services Secretary Mike Leavitt said the Senate bill goes too far in the wrong direction to win administration support. Leavitt wrote in a June 26 letter to Sen. Edward Kennedy (D-Mass.), chairman of the Health, Education, Labor and Pensions Committee, that the Wired for Health Care Quality Act would create significant barriers to progress under way.
“The draft legislation would undo what is presently a successful health IT public/private partnership and stop current work in its tracks,” Leavitt wrote.
Kennedy’s committee passed the bill by voice vote June 27, one day after its official introduction. “It’s long past time for the nation’s health care industry to adopt” modern IT, Kennedy said in a statement. “Such technology has revolutionized a wide array of American industries, and it holds the same promise for the health care industry.”
Leavitt, who said administration officials concurred with his views, objected to the bill’s provisions concerning two advisory panels, including the American Health Information Community, an HHS advisory committee that the secretary leads. Without changes in provisions concerning the two panels, the letter states, Bush would oppose the bill.
Leavitt wants to convert the AHIC panel from a federal advisory committee to a nongovernmental organization, partly so politics wouldn’t affect it as much. The Senate bill would freeze AHIC in its current status and call for Congress to appoint community members. Leavitt wrote that such a move “would politicize the successful collaborative work ongoing through AHIC” and would create barriers to rapid transformation.
Leavitt said the bill’s provisions to create a second advisory panel — the Partnership for Health Care Improvement — would be counterproductive and would add “a layer of complexity to the health IT governance structure.”
Leavitt also disagreed with measures for creating grant programs to spur health IT adoption. “The most appropriate and efficient ways to achieve widespread use of health IT are through market forces rather than through direct subsidization of health IT purchases,” his letter states.
The Senate bill under consideration would provide grants for low-income health care providers to buy health IT systems. Providers use the grants for establishing health information exchanges, telemedicine programs serving residents of more than one state, and health IT training. The bill would create a state-run loan program to finance providers’ acquisition of systems.
Leavitt said he also objected to the bill’s provisions that would create quality-reporting organizations, require HHS to designate a single organization to promote development of performance measures for health care, establish a health resource center in HHS, and extend the privacy rules under the Health Insurance Portability and Accountability Act of 1996 to operators of e-health record repositories and exchanges.
Leavitt wrote that HHS and AHIC are considering privacy and security protections that should apply to various entities. It would be premature to extend HIPAA coverage, he added.
A leading advocate of health IT, the Healthcare Information and Management Systems Society, has not taken a position on the bill. “We are pleased that the Senate is focusing” on health IT, said David Roberts, HIMSS vice president for government relations.
From the battlefield to the home front: Managing medical data
Government Health IT presents Col. Claude Hines Jr., program manager for the Defense Health Information Management System, in this recent InSight eSeminar. Col. Hines discusses the health information technology and tactical challenges faced by the military medical community in Iraq, Afghanistan and other areas of conflict. In doing so, he describes the current information technology solutions for transferring clinical data between battlefield care givers to health care personnel at military treatment facilities worldwide.
