Lawmaker May Have Key to Speeding Electronic Records Adoption

The chair of the House Ways and Means Health Subcommittee has introduced legislation to provide financial incentives to propel the adoption of electronic health records.

Rep. Pete Stark (D-Calif.) has introduced the Health-e Information Technology Act of 2008 (HR 6898), which requires the government to create standards for an interoperable health information technology system, as well as the creation of an open-source health information technology (HIT) system that will be made available at little or no cost to all providers. It also provides incentives to drive the adoption of standardized, interoperable HIT systems and includes strong, workable protections for the privacy of personal health information.

“If we want a uniform, interoperable health care system in America, time has shown us that we can't depend on the private sector to do it on [its] own,” Stark said. “This is the perfect role for government. We should work with stakeholders to develop the standards, ensure an affordable product is available, and pay providers to adopt it. That's exactly what the Health-e Information Technology Act does.”

The AMA reacted positively. “The AMA commends members of Congress, including Chairman Stark, for recognizing the importance of moving toward an interoperable, nationwide HIT infrastructure and for recognizing the crucial role the federal government plays in assisting the health care industry to accelerate the adoption and implementation of HIT systems and tools,” said Rebecca Patchin, M.D., chair-elect of the AMA's Board of Trustees, in a press statement.

The bill would codify the Office of the National Coordinator for Health Information Technology (ONCHIT) within the Department of Health and Human Services, an office created by Executive Order in 2004. In coordination with an advisory committee representing private and public stakeholders, the national coordinator would be responsible for creating standards to achieve widespread adoption of interoperable, secure, and clinically useful electronic health records. The national coordinator is Robert Kolodner, M.D., a psychiatrist.

If the bill passes, the first generation of these standards would be finalized no later than October 2011. In addition, to ensure availability of an affordable system and increase choice and competition, ONCHIT would coordinate the development of a certified open-source HIT system that meets the standards it established. This system would be available to health care providers at low cost as soon as possible, but no later than nine months after the standards are set.

Physicians who install and use an approved system would be eligible for incentive payments totaling up to approximately $40,000 over five years, while hospitals that do the same would be eligible for incentive payments of up to several million dollars. These incentives would phase out over a few years, at which point Medicare payments would be reduced for those who do not use qualified systems.

An analysis HR 6898 is posted at<www.house.gov/stark/news/110th/legislation/200809-HIT/analysis.pdf>.▪