Get the Government out of Health Information Technology
February 18, 2015
At the end of 2014, the federal government's Office of the National Coordinator of Health Information Technology (ONC) proposed a 10-year federal plan for Health Information Technology (HIT). What's HIT? It can refer to everything from products to services and includes electronic health records (EHRs), telehealth technology, medical devices, remote monitoring devices and more. Basically, it's the use of information technology within the health care sector.
NCPA Senior Fellow John R. Graham has issued a new report responding to that federal proposal.
The federal plan calls for expanding the adoption of HIT, advancing interoperable health information, strengthening health care delivery, advancing the health of individuals and communities and advancing research and innovation. Those goals, says Graham, are not objectionable -- what is worrisome is the federal government's role in expanding and coordinating HIT. Already, the Federal Health IT Advisory Council includes 35 federal agencies, from the Federal Communications Commission to NASA.
Graham says the federal government's role in HIT should be reduced significantly, pointing to the government's failure in promoting the adoption of Electronic Health Records (EHRs) -- despite federal incentives to encourage hospitals and doctors to adopt EHRs, it is unlikely that the government will meet its targets. In fact, the government gave hospitals and doctors subsidies to purchase EHRs, but rules regulating their use have cost doctors significant productivity time. Graham cites the experience of one doctor, Mark Skylar, who says he spends 90 minutes each day "entering mostly meaningless data" into the record system in order to avoid penalties from Medicare, time which would be "better spent calling patients to answer questions" or stay "updated with the medical literature." Moreover, while the physician had adopted Medicare's requirements for electronically prescribing medications, he found that many of his patients did not want electronic prescriptions. Yet, Skylar is required to electronically prescribe certain numbers of prescriptions, or he faces a reimbursement penalty.
Moreover, many EHRs are not "interoperable" -- as Graham says, "different EHRs do not speak to each other," despite that the idea behind electronic health records was that health care providers could and would exchange information with one another.
Graham says the EHR experience should serve as a warning about federal involvement in HIT. He concludes, "As HIT expands in unpredictable directions, the federal government should exert a humble and light regulatory touch; and refrain from the temptation to spend more money to encourage the types of technologies preferred by the government, instead of patients and providers."
Source: John R. Graham, "Roll Back the Federal 10-Year Strategic Plan for Health Information Technology," National Center for Policy Analysis, February 2015.
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