Bush Creates Post to Lead Medical-Records Switch

President Bush says incentives are key for advancing the transition to electronic medical records, but industry insiders say outright grants to health-care providers may be most effective.

President Bush has created a new position to advance the transition to electronic medical records. The Department of Health and Human Services official, who has not yet been selected, will be largely responsible for coordinating the public-private partnerships necessary to get health-care systems across the country to use compatible standards and methods.

The announcement wasnt surprising, said Lorraine Fernandes, senior vice president of health-care practice at Initiate Systems Inc., which sells software and services to manage patient identities.

But choosing the right person is important, Fernandes said. Whoever fills the post will need to quickly win trust and build consensus among consumers, providers and vendors—groups that often have disparate needs, she said. "Someone controversial wont push this forward."

Bushs announcement was joined by other proposals, including an increase of $50 million in grant funding for community health providers to adopt IT systems, as well as a request for the Centers for Medicare & Medicaid Services to draw up plans for creating incentives to implement IT systems.

"Within ten years, every American must have a personal electronic medical record," Bush said at a conference in Minnesota of the American Association of Community Colleges. "Weve set out money to encourage demonstration projects that will show the health-care providers the need to use electronics to make their records system more modern."

/zimages/3/28571.gifClick here for a transcript of the presidents speech at the convention.

But Fernandes said health-care providers would likely find outright grants more useful than incentive programs.

Vendors often make contributions in terms of IT software and human resources, she said. "Its much easier for a vendor to make those types of gestures in a private consortium than in something that the federal government might put forward," she said, adding that companies helping hospitals to link patient records across a community could encounter discouraging red tape in public programs.

Senator Max Cleland, D-Ga., criticized Bushs proposal as an empty gesture, citing a $472 million computer system at a veterans medical center in St. Petersburg, Fla., that delayed surgeries and compromised physician care, according to the Baltimore Sun.

But a recent article from Baseline described how the U.S. Department of Veterans Affairs overcame its initial struggles to share medical records electronically.

/zimages/3/28571.gifTo read more about the challenges the department faced, click here.

One solution is for the government to fund a percentage of health-care providers costs toward building more automated health-care systems, Fernandes said. For example, Infoway, an agency funded by the Canadian government, does this for vendors that process radiology images, so the images can be viewed by common electronic systems.

The Infoway program also funds efforts by provinces to build a client registry that can link patients across a province. Such data sharing can help doctors know about treatments a patient has received from another health-care provider—information doctors need to provide the best care.

Both Canada and the United Kingdom have implemented systems for doctors to access medical records that are much further along than systems in the United States.

The Bush administration claims that, once in place, the system could be used to detect epidemics or even bioterrorism attacks by detecting unusual numbers of patients with certain symptoms.

But that doesnt mean that authorities could create lists of all patients taking a particular drug or undergoing a certain procedure, Fernandes said. "A lot of whats going to be done is going to be on a need-to-know basis, and that theory is already written into the HIPAA [Health Insurance Portability and Accountability Act] legislation."

Read the presidents agenda for health-care IT on the White House Web site.

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