As members of Congress weigh legislation to create a nationwide system of electronic health records, states are poised to act quickly through coordinated efforts with healthcare providers, industry, and the federal government, according to a report released today by the State Alliance for E-Health, a panel created by the National Governors Association. Most urgently, states should encourage electronic prescribing and protect patient privacy, the authors said.
Comment on this article in The Forum.The report said adoption of e-prescribing has been slow, even though the necessary infrastructure and standards exist. Congress helped by approving a veto-proof Medicare reimbursement bill in July that included incentives for physicians who use e-prescribing starting in 2009. In addition, privacy and security measures are important because public trust can make or break an e-health effort, the report said, noting that states must ensure consistent policies to protect data and secure exchange.
In many cases, privacy and security requirements are scattered among different chapters of state legislation and regulation, some of which are outdated because they were written for a paper-based system. States should consolidate and update relevant statutes for the electronic age and support efforts to reduce variation of state privacy requirements. The report noted that several Gulf Coast states, for example, have already formed a task force to reduce privacy and security vulnerabilities and work on plans to support interoperable e-health systems across the region.
The alliance, which is chaired by Tennessee Gov. Phil Bredesen, a Democrat, and Vermont Gov. Jim Douglas, a Republican, noted the importance of interoperability, citing the high cost of overhauling "legacy" systems to enable greater connectedness.
The report gives a nod to the federal government for already having launched several initiatives aimed at creating a broad framework to "securely connect providers, health systems, consumers, and communities to electronically share health information as necessary and appropriate." The paper urges states to keep tabs on those efforts and participate in standard-setting processes.
"We must harness our American ingenuity to bring about a technological revolution in America's healthcare system," Douglas said in a statement. Bredesen added that the United States spends more per capita on health care than any other developed country but has failed to achieve the results citizens deserve.
"Improving e-health is about improving a patient's overall healthcare experience, from increasing efficiency and coordination of health care and reducing duplicative visits to preventing medication errors and protecting the public's health," he said.