The message is trickling through: IT and quality must be part of reform

Congress passed, and President Obama signed, the American Recovery and Reinvestment Act into law back in February, including some $35 billion or so in funding for EMRs and other health IT. (Based on estimated efficiency gains from the technology, the net federal spending estimate is $19.2 billion)

Since then, the health IT sector has been energized like never before, and the national debate shifted to broader "healthcare reform." I put that phrase in quotations because most, if not all, of the debate has been about how to expand insurance coverage--not to address the serious quality problem or fix the sadly misaligned incentives that encourage doctors, hospitals, pharmacies, imaging centers, laboratories and long-term care facilities to see more patients, fill more beds, order more tests and generally perform more billable services.

All the noise over the summer--and I mean all the noise--has been about the role of government in moving toward the universal insurance coverage. While I certainly believe universal coverage is an admirable goal, the problem with viewing coverage in isolation is that having insurance with fewer exclusions and less chance of rescission just means someone else will pay when you get care, subject, of course, to deductibles and co-payments. It does not mean you will get good care, nor does it mean you will get the appropriate services. It also perpetuates a convoluted system of reactive, sick care rather than promoting a culture of proactive prevention. It may not even change the habits of those who have become conditioned to going to an ER every time their children get a runny nose.

I've been critical of this so-called healthcare reform in previous columns, particularly over at FierceEMR, but I felt like my cries were falling on deaf ears. Well, first of all, I'm now writing here for FierceHealthIT and its larger audience. But, more importantly, others with far more influence than I are making their voices heard.

My FierceHealthIT Editor's Corner last week noted the waning of National Health IT Week, and was dismissive--before the fact--of the Capitol Hill press conference meant to highlight the role of IT in healthcare. I noted that the congressional speakers generally say the same thing: "We support health IT as a great way to modernize our healthcare system, bring down costs, improve access to care and prevent medical errors." Then they go back to work and do nothing to back up their empty rhetoric.

Well, I was pleasantly surprised to read the account of last week's press conference in Healthcare IT News. A group called Health IT Now! (exclamation point included) said it would continue to advocate for health IT to be included in any further healthcare reform legislation. Rep. Patrick Kennedy (D-RI) said that Congress and the administration should continue to offer health IT support to healthcare providers through legislation, grants and administrative guidance, "would continue to need support via legislation, grants and agency guidance, especially with the logistics of applying for funding and adopting electronic health records," Healthcare IT News reports.

Sen. Sheldon Whitehouse (D-RI) furthered the discussion by calling on Congress to assure that health IT becomes part of the culture at hospitals and medical practices, and that there is evidence of the efficacy of EMRs to back it up. "We have to make sure we are not lifting all boats just a little bit," Whitehouse said, according to Government Health IT. "Across all other industries, we have seen how information infrastructure works for the American consumer."

The story further notes that a compromise bill offered by Senate Finance Committee Chairman Max Baucus (D-MT) would encourage value-based purchasing and coordination of care for Medicare beneficiaries. Unfortunately, this centrist bill has been panned by both the left and the right for proposing either too much, or not enough, government involvement in insurance reform. But it's a start.

Now let's see if anyone else is listening. - Neil

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