Paying Doctors for Outcomes, Not IT, Should be Health Focus, CAP Says
Whether health IT is a boondoggle or salvation depends on how it’s implemented, speakers said on a conference call Friday. Sen. Sheldon Whitehouse, D-R.I., and fellows from the Center for American Progress laid out what they believe must be done to ensure the health IT provisions of the Recovery Act provide the improved care and decreased costs promised. Whitehouse again warned of “tragic cuts” that will have to be made in the near future if healthcare costs aren’t contained, with health IT being part of that containment strategy.
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Whitehouse said it’s natural for people to raise questions when a large amount of money is scheduled to leave federal coffers for a single industry and when there’s no automatic relationship between the outlay for technology and savings. Savings innovation has been “categorically stunted” in healthcare, he said. Doctors and hospitals would have to pay to install health IT, while the insurance companies would reap most of the reward of lower costs, he said. But the U.S. can’t wait for the time when investing in health IT becomes a sure thing for doctors, he said. Instead, it must be viewed as infrastructure, for which the government should make an investment, he said.
The project requires intelligent management, which Whitehouse said the Obama administration will provide. CAP Senior Fellow Judy Feder said the spending could be a boondoggle. “Implemented badly, of course it would,” she said. It could also be a catalyst for transformation of the health care system, she said.
To ensure health IT produces results, CAP Senior Fellow Todd Park said there must be pay reform and a diligence to not treat it as a purely technical program. The definition of “meaningful use,” under discussion by a federal advisory committee, should initially focus on things such as tracking key patient information, applying clinical decision support, e-prescribing and e-labs and quality metrics, he said. By years three to five of the incentive payment program, providers should be paid based on their care results derived with the help of health IT, he said.
CAP also submitted comments, along with the Markle Foundation, Center for Democracy and Technology and several others, to the Health and Human Services Department about data-breach requirements included in the Recovery Act. The groups supported the encryption standards suggested by HHS and suggested adding a one-way hash function to turn text into a string of digits.