Nearly a decade after Americans' initial encounters with the Internet, and not long after President Bush called for every American to have an electronic medical record by 2012, policymakers are rallying en masse to bring the benefits of information technology to health care.
Bills pending in Congress would provide financial incentives for providers to adopt medical IT systems and promote interoperability between those systems. Since most people have had more than one health plan and have visited more than one provider — often in multiple states — establishing strong standards for IT system interoperability is essential to the broad expansion of medical IT and should be Congress's first priority.
Provider incentives and interoperability standards will increase the use of medical IT innovations and provide a strong foundation for quality improvement. However, health care quality and affordability cannot truly be transformed without making sure the health care system uses IT most effectively to benefit patients.
A recent Alliance of Community Health Plans (ACHP) report synthesized current literature discussing variations in health care, and the findings are eye opening. Americans receive, on average, recommended care only about half the time. In addition, higher levels of spending do not always promote better outcomes and patient satisfaction.
If Congress and the health care industry succeed in expanding medical IT but fail to drive health care to use IT the most effectively, we risk creating a system that perpetuates — not reduces — the already significant variations in care and quality that ACHP, the Institute of Medicine, the National Committee for Quality Assurance, and, most recently, Rand Corp. researchers have observed. As policymakers continue to examine ways to connect more of the nation to medical IT, they should challenge the entire health care system to improve along with those innovations.
The broad installation of IT systems will make it easier for providers and plans to report information about quality and cost. They should be required to do so to create an environment that encourages transparency and reliable information, that compares plans and providers on a level playing field.
It is also time for patients to become more involved in health care decision-making with their providers. This requires tools to help providers and patients make evidence-based decisions.
Proposals to encourage the broad development of medical IT should also adhere to the principle that patients — not health plans, providers, or the government — own their health care information.
Government can play a role in quality improvement by offering financial incentives to providers who deliver outstanding quality. This encourages lesser-performing providers to improve.
Establishing a national health information network is a substantial task that will continue to challenge private and public sector budgets. Yet HHS projects that such a network could save about $140 billion per year, due in part to savings from improved care.
Although election year politics and strained budgets may diminish the political imperative for action on medical IT-related measures, strong bipartisan support and the potential for promoting broad quality improvement in American health care should give it a prominent place on the domestic agenda.