A Stagnant Seven Years?

Maureen Larkin, for HealthLeaders Media, January 31, 2008

For Americans who listened to President George W. Bush give his final State of the Union speech Monday night, it was the same old story when it comes to healthcare.

Our president told us he wants to see more affordable and accessible healthcare, tax breaks for those without health insurance and an end to junk medical lawsuits. Nothing new there. The president has touted these changes in each of his annual addresses since he first took office in 2001. Hearing the same things year after year, it's easy to believe that the president has achieved little in healthcare during his seven years in office.

That isn't to say that things are just as they were in 2001. The cost of healthcare continues to skyrocket. Frivolous medical malpractice suits continue. Emergency rooms are overburdened. The number of uninsured Americans continues to grow. Hospitals continue to make high profile errors, putting patient lives at risk.

Perhaps the thing that President Bush has made the most progress on is something that he didn't specifically mention during Monday's address: Electronic medical records. First mentioned in his 2004 State of the Union speech, President Bush put forth an effort to have electronic records available to most health consumers by 2014 to improve the quality of healthcare that Americans receive. His idea was to make sure that no matter where a patient sought care, caregivers would have complete access to the patient's medical history and information. Doctors would know what medications the patients were taking, what they were allergic to, and what ailments they've experienced before. There would be no more duplicate tests, no medication interactions, no allergic reactions. Preventing these three things alone could not only make patient care better, but save hospitals and insurance companies money in the long run.

So where are we on this effort? In 2006, the U.S. Department of Health and Human Services put out a report about the Health Information Technology Initiative, outlining its progress on gathering information and creating uniform standards for electronic record use. The first national coordinator for health IT, an advisor to the secretary of HHS, was appointed to give advice on the actions needed to make electronic records a reality. Committees were formed to examine health IT products, security, anti-fraud activities, standardized adoption methods, best practice guidelines and more. One of these committees, the Certification Commission for Healthcare Information Technology, certified 37 electronic health record products for use in clinician offices in 2006.

Despite these efforts, though, Congress hasn't passed health IT legislation during the last two years and funding has been scant. A report released January 18 by the California HealthCare Foundation questions the effectiveness of the Nationwide Health Information Network initiative. CHF calls the goal "worthy," but "impractical" and says it "cannot be implemented."

CHF makes sure to point out that it believes the president's goal of health IT adoption by 2014 is still possible, and has been successful in laying the foundation for health IT and electronic health record adoption. "Yet, it cannot be said that the nation is substantially closer to a ubiquitous, interconnected, interoperable HIT system now than when the president called for action in April 2004," the report says.

So, what do you, a Quality Leader, think? Are we any closer to having electronic health records connect our doctors' offices, hospitals and clinics? Will we see a day where we'll know everything about a patient's medical history the second they walk in the door? If we do, will it improve the quality of American healthcare, as the president proclaimed during his 2004 speech? Will these efforts be interrupted by the change in power that our country will see this time next year?

It remains to be seen who will lead us to the year 2014, or the commitment that leader will have to seeing the health IT initiative through. I'm interested to hear what you think about our health IT progress and whether technology is truly the solution to improving quality and solving America's healthcare problems.

Maureen Larkin is quality editor with HealthLeaders magazine. She can be reached at mlarkin@healthleadersmedia.com.

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