Health IT bill advances in Senate; grants have bipartisan support
■ The federal government may spend $278 million to help physicians buy information technology.
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Washington -- A leading bipartisan bill to promote health care information technology by establishing physician grants and a process for recommending health IT standards passed one of its first hurdles last month.
The Senate Health, Education, Labor and Pensions Committee unanimously approved the measure on June 27. Supporters hope for a quick vote in the full Senate before it adjourns on Aug. 6 for its summer recess.
The Wired for Health Care Quality Act includes $278 million to purchase health IT. It would offer matching health IT purchasing grants ($3 for every $1) to physicians who deliver care to underserved populations and who demonstrate financial need. The legislation also would provide dollar-for-dollar matching funds to states to make low-interest loans to physicians for purchasing health IT.
A new public-private board would recommend to the Dept. of Health and Human Services the technical aspects, such as interoperability, that health information record systems should follow. Federal public health programs would be required to follow the standards ultimately selected by the president. This would be optional for private organizations.
The bill, sponsored by Sens. Edward Kennedy (D, Mass.), Hillary Clinton (D, N.Y.), Orrin Hatch (R, Utah), and Mike Enzi (R, Wyo.), also would extend HIPAA privacy rules to companies that run health information databases. It would require that any national health IT policy include methods to notify patients when their privacy is compromised.
A small, but potentially controversial provision, would allow for public reporting of physician performance data by one of three quality reporting organizations. The American Medical Association has "serious concerns" with this part of the bill, especially since it would rely on less-accurate federal claims data, instead of health record data.
The provision "fails to take into account the importance of physician involvement in performance measure development and the considerable efforts of the AMA-convened Physician Consortium for Performance Improvement," said AMA Board Chair Edward L. Langston, MD.
The bill has pluses and minuses, said Medical Group Management Assn. Senior Policy Adviser Robert Tennant. The $278 million would not go far, he said. "Just one of our member practices spent $140 million on their system."
Establishing another layer of bureaucracy also would slow down the adaptation of standards for health information systems to talk to each other, Tennant added.
Still, the legislation would promote interoperability, and by strengthening patient privacy protections, it would encourage the public to use a health IT system, he said.
Though small, the funding stream for physician grants and loans could increase after it is established, said American College of Physicians President David C. Dale, MD. The ACP is particularly interested in the bill because it would help physicians in small practices and areas where it is harder to finance health IT, he stated.
Hope for quick Senate passage
The legislation will fill a void, Enzi said. "Doctors, hospitals, health care advocates and the business community ... are clamoring for Congress to take action and establish uniform health IT standards," he said. "Time is of the essence -- if we do not act, our health care system will move forward in a highly inefficient, fragmented and disjointed way."
With luck, the Senate will vote on the bill before recessing in early August, said Senate HELP Committee spokesman Craig Orfield. Enzi and Kennedy will urge Senate Majority Leader Harry Reid (D, Nev.) to hold a vote as soon as possible, said Orfield.
"It's long past time for the nation's health care industry to adopt modern information technology," said Kennedy in a statement after the vote.
The legislation has enough support in the Senate to pass, predicted Orfield. The committee's votes are often a reliable indication of how the full Senate will act, he said.
Outlook in the House
The measure is a "step forward" and shows that Congress is still interested in health IT, said Don Asmonga, director of government relations for the American Health Information Management Assn. But he expressed concerns that the House would not act quickly.
"I have yet to hear that [health information technology] is on their list of top three priorities," he said. The State Children's Health Insurance Program, Medicare physician payment reform and underinsured Americans are the most pressing concerns in the House, he stated.
Asmonga hopes Congress will combine the Senate's bill with a health information measure passed by the House last month.
The "10,000 Trained by 2010 Act," as the bill is known, would appropriate $100 million in grants to institutions of higher education for research and training in health information technology. The House measure is more focused on information management and training, and commits funding, Asmonga said.
The Wired for Health Care Quality Act proves that there is a bipartisan group in the Senate interested in advancing health information technology, said Doug Peddicord, vice president at Washington Health Advocates, which lobbies for the American Medical Informatics Assn.
AMIA, a nonprofit organization focusing on the organization and management of medical information, would like to see stronger support for clinical training programs in the Senate bill. The measure would only set aside $4 million in 2008 and 2009 for clinical training programs.
A consumer advocate pressed the Senate to strengthen patient privacy provisions in the bill. "Americans should be given the right to opt out of national IT systems, and the Senate bill currently does not address this key privacy issue," said Consumers Union Senior Policy Analyst Bill Vaughan.