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INSIDE THE CURRENT ISSUE |
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Fiscal aid a miss without HIT Premier urges economic stimulus funding for healthcare information technology by Rick Dana Barlow W hat a difference 17 years makes. Or maybe not. When it comes to healthcare policy and reform, history seems to be repeating itself. The last time healthcare was so popular an election issue and garnered considerable post-election attention was 1991. Back then, the economy had slid into a recession during a presidential election that saw a Democrat pick up the baton from a Republican. Just like 2008.But also back then, a federal economic stimulus package plan
approaching a trillion dollars seemed unfathomable. Not And this time around healthcare organizations, such as Premier Inc., proactively are calling for a noteworthy chunk of the billions to cover the development, adoption and implementation of information technology to improve quality, reduce errors and generate long-term efficiencies and savings in an industry historically bloated on wasteful practices and spending that some argue are regulatory inspired. Premier specifically sent a letter to Congressional leaders urging them to include provisions for "federal standards development and [electronic health record] certification for seamless quality reporting" and "substantial funding for providers" because "high acquisition and implementation costs and lack of common interoperability standards have made substantial progress difficult," according to the letter. [Editor’s Note: Visit HPN Online to read a copy of the letter.] In a brief telephone interview five days before the presidential inauguration, Healthcare Purchasing News Senior Editor Rick Dana Barlow spoke with Blair Childs, Premier Inc.’s senior vice president, public affairs, about his organization’s efforts to push for investment in healthcare information technology as a key provision within a healthcare economic stimulus package.
I’d say it’s better than a 50 percent chance that there will be a significant funding boost for healthcare IT – a substantial boost for hospitals. We’re looking at $15 billion to $25 billion for healthcare IT overall. How that gets allocated still has to be decided. There’s a high probability it will be included in the overall stimulus package. The issue is how quickly that money will be released. Are we ready to pay for IT if we don’t have standards for IT interoperability? Everyone wants to make sure that it’s accountable. Are you anticipating this happening in 2009? We’re hoping for it. I think there’s a sentiment on the Hill that that money shouldn’t be released until standards are adopted – interoperability and data standards. So it may not be for a couple of years. Certainly, GS1 is one set of standards but that doesn’t fit in with EHR. There’s a lot of debate in Washington about EHR. How much effort is Premier dedicating to appealing to popular healthcare IT advocates, such as [former House Speaker] Newt Gingrich or [former National Coordinator for Health Information Technology] David Brailer, M.D., Ph.D? As much as I think they’re leaders we’re very focused on the people making the decisions right now. They are commentators but not decision makers. We need to reach those who are going to be doing healthcare IT work. Editor’s Note: Since leaving the Bush Administration, Brailer now serves as Chairman, Health Evolution Partners, an investment firm that specializes in healthcare companies. Gingrich founded the Center for Health Transformation, a think tank advocating the adoption and implementation of healthcare IT. Let’s shift gears. Will Premier be sending a similar letter to Sen. Herb Kohl (D-WI) for his GPO-interested Senate subcommittee, either as an effort to show him of Premier’s intent to improve healthcare operations or as an effort to blunt any reinvigorated legislative attack on GPO operations now that two of three branches of federal government are solidly Democratic – and presumably not GPO-friendly? I don’t see anything on the horizon about GPOs at all. I would say that members of Congress I talk to – Republicans and Democrats alike – recognize the critical role that GPOs play in the industry and they’re very supportive. We’re in an environment where cost reduction is critical, and GPOs are effective mechanisms to reduce costs and inefficiencies. We also feel that a lot of the concerns Sen. Kohl raised have been addressed. How will Premier encourage member hospitals to adopt and implement the necessary IT tools to further demonstrate its commitment to healthcare performance improvement? Examples may include contracting with vendors to offer a variety of IT tools at a heavily discounted rate - or even free; working with clinicians to train them on how to use IT tools effectively; or offering incentives – either in the form of reduced fees or end-of-year bonus checks or something else – for IT tool adoption and implementation? That’s a really good question. I can’t give you a number. In conversations I’ve had with some very influential organizations, from Geisinger to Aurora, almost all are heavily invested in this area. In addition, Premier has the largest clinical database in the country for hospitals to use to benchmark with one another. So I can’t give you an exact percentage of members in the process of fully integrated EMR, but I know that we have a large number of members who are far enough along to transmit information between hospitals and physicians and so forth. But with this letter Congress might look to Premier organizations for examples so doesn’t it make sense to lead the way? We do a lot to share best practices among our organizations
in this area. There’s a learning process for hospitals. A lot of this comes
down to capital investment and necessary funding for it. It’s a policy issue
for Washington. Let’s face it: Medicare and Medicaid do not adequately pay
to cover the costs of caring for patients so how can they do it for IT?
Hospitals need sufficient financial incentives so they don’t have to shift
costs or go farther into debt. Plus, standards will have to be adopted.
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