Lawmakers Propose High-Tech Medical Records

A bipartisan group of lawmakers unveiled plans Wednesday to push the paper-based U.S. health care system toward the high-tech system seen in banks, airlines, and other industries.

House members introduced a bill that would authorize $50 million in grants and loans in 2006 targeted to speeding the development of electronic medical records, so-called "e-prescribing," and computerized billing.

The goal is to come up with common standards so that the system can be used by doctors, pharmacists, hospitals, and insurance companies. This will allow the paper-based system to be phased out, hopefully cutting down on medical errors, prescribing mistakes, and waste.

Experts have long argued for the need to improve information technology in the U.S. health care system, which remains rife with high costs and inefficiency. A 1998 report from the Institute of Medicine pegged inefficient, paper-based communications as a key driver in medical mistakes that kill an estimated 48,000 to 98,000 Americans each year.

But while few disagree on the need for a higher-tech health care system, standards have not yet been established to allow different health system players to communicate.

Supporters Wednesday said their bill would help find a standard by extending grants to new regional health information organizations. The nonprofit groups would spend the money to develop paperless medical and billing systems in their areas.

"The alternative is the continuation of the centuries-old pencil-paper practice," said Rep. Tim Murphy, R-Penn., one of the bill's chief sponsors.

"Today can be the end of having to fill out that confounded clipboard that all of us have to fill out" in doctors' waiting rooms, said Rep. Patrick Kennedy, D-R.I.

Under the bill, private companies have nine months to agree on technological standards for electronic medical records. The secretary of Health and Human Services has the option of unilaterally setting the rules if industry fails to make the deadline.

Common Ground on IT

President Bush has often mentioned improved health care technology as a way to reduce medical errors and cut health costs. The administration has backed the idea of similar grants to those included in Wednesday's bill.

Finding enough incentives for physicians to abandon paper systems could prove difficult. While large health systems and hospitals have millions to invest in technology, many doctors in solo and small group practices warn that new systems will be too expensive for them to buy.

Groups have also raised concerns that electronic records could be vulnerable to privacy violations or theft. Grants under Wednesday's law would only be given to projects that enact specific privacy protections, sponsors said.

Also Wednesday, a group of CEOs from large U.S. corporations gave their backing to industry-led efforts to spread electronic health technology. Health and Human Services Secretary Michael O. Leavitt told reporters following a meeting with the CEOs that the bill "appears to be compatible" with Bush administration policies.

But Leavitt also cautioned that the grants would be only the start of a long process, including finding ways to convince doctors to buy new technology.

"This is not a simple matter, nor does it lack complexity. This is a substantial social and economic transition we are embarking on," he said.

By Todd Zwillich, reviewed Brunilda Nazario, MD

SOURCES: Rep. Tim Murphy, R-Penn., Rep. Patrick Kennedy, D-R.I., Michael O. Leavitt, secretary, Health and Human Services.