How Should Congress Handle Health IT?

WASHINGTON — Reforming the nation’s healthcare system is never a simple proposition. Add in sweeping initiatives to bring the medical industry into the digital age, as President-elect Barack Obama has called for, and another wrinkle is added to the already-complicated issue.

At a panel discussion here at the annual conference of the Advisory Committee to the Congressional Internet Caucus, a group of experts involved in the debate outlined some of the steps they’d like to see lawmakers take as they mull health IT initiatives, including privacy assurances and holding providers accountable for how they use federal funds.

The issue is a timely one, as the Senate Committee on Health, Education, Labor and Pensions plans to consider using money from the proposed economic stimulus package to fund IT healthcare at a hearing Thursday.

At the same time, tech firms such as Microsoft (NASDAQ: MSFT) and Google (NASDAQ: GOOG) have launched major initiatives aimed at bringing medical records online so they are more accessible to patients.

“We’re really excited about the prospect of actually being able to do more stuff with your personal health information online, and receive guidance in your own homes as opposed to having infrequent and sporadic interactions with the healthcare system,” said George Scriban, senior global strategist for Microsoft.

Microsoft’s product is called HealthVault. Like Google Health, the service is aimed at giving patients secure online access to their medical information while inviting developers to write applications that make medical data more useful and accessible.

Despite the companies’ security assurances, privacy advocates would like to see Congress incorporate significant safeguards to protect sensitive medical information as a provision for any funding it allocates for healthcare IT.

Deven McGraw, director of the health privacy project for the Center for Digital Democracy, a digital-rights advocacy group, said Congress needs to adopt a tiered set of privacy rules that would establish different access provisions for patients and providers.

“The rules that we need to put into place for how healthcare providers exchange information via electronic medical records in my view need to be very different from the rules that need to be put into place for example when you’re talking about personal products that are designed for the consumer to use,” McGraw said.

Next page: privacy concerns.

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Scriban acknowledged that the privacy concerns are serious, and said that any effort to digitize healthcare information would only win over consumers if it had stringent safeguards.

“We’re well aware of the paramount importance user trust has in the uptake and acceptance of something like HealthVault. And Google knows the same thing,” he said.

“From our perspective, our incentives are to protect and to act very aggressively on behalf of the consumer are pretty clear and well aligned for us. If the consumer doesn’t feel that they’re in control of their personal health information, they’re simply not going to adopt a personal healthcare platform like HealthVault,” Scriban added.

But it’s not only a question of getting consumers on board. Doctors and insurance providers need to buy into the concept as well. David Lansky, president and CEO of the Pacific Business Group on Health, a California organization working to improve and simplify the healthcare plans for the large firms it represents, said that hasn’t been an easy task so far.

“Every one of those organizations has been transformed by technology and has [made] it a routine requirement to deploy technology to improve the quality and efficiency of those services,” he said. “It is paradoxical and troubling for my members that the healthcare industry has not made a similar commitment to transformation.”

More broadband needed

The panelists agreed that government support for expanding broadband deployment would be a great boon to healthcare IT.

“Broadband is kind of a no-brainer that we need to drive that infrastructure,” said Steven Waldren, director of the American Academy of Family Physicians’ Center for Health IT.

Obama has signaled his intention to spur broadband build-out, and it is widely expected that the proposed stimulus package will contain some funds for network expansion. However, an Obama aide speaking earlier today at the conference downplayed the role broadband would play in the stimulus.

Blair Levin, one of Obama’s top tech advisors, said that broadband would be an ongoing priority, suggesting that the stimulus package would only be the tip of the iceberg in the administration’s efforts to promote high-speed Internet access. “Don’t confuse the piece with the puzzle,” Levin said.

But while it would certainly spur e-health measures such as telemedicine and electronic prescriptions, broadband deployment might not be as important as a full-on embrace of the technology from the medical community.

“The main thing is we need to get the providers that are providing the healthcare connected with technology,” Waldren said.

The panelists agreed that any money that Congress allocates to promote healthcare IT should come with conditions that hold providers accountable for putting it to good use. Federal money could upgrade physicians’ systems and create sophisticated new portals, but if it doesn’t change the way they practice medicine, it would be a waste of resources.

The panelists also agreed that it is too early for Congress to require health information to be digitized according to a certain data standard. They said that the market for healthcare IT is developing so rapidly that the standards available today could be obsolete in a short period of time.

“We don’t need to wait on standards bodies to finish their work and be complete before we start implementing,” Scriban said.

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