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With a little cash, health IT on the way

The new federal center set up to launch U.S. health care into the digital age has already certified more than 600 new health information technology products and is ready to start helping providers set these systems up, its new head said on Tuesday.

Farzad Mostashari, just two weeks into his new job as national coordinator for health information technology, said at a Bipartisan Policy Center panel discussion that his office has opened 62 regional "extension centers," which aim to help providers understand and set-up health IT programs.

The center, set up under the Health and Human Services Department, has started curricula at 82 community colleges around the country to focus on health IT. And most notably, Mostashari said, the agency has established competition in the marketplace, certifying more than 600 products from nearly 400 vendors that the federal government will accept for providers to get bonus payments.

Providers can receive up to $44,000 in incentive payments from the Centers for Medicare and Medicaid Services over five years, but they must start using electronic health records next year to be eligible for all the cash. After 2015, providers will take a cut in their Medicare reimbursements if they are not using health IT up to government standards.

Mostashari said private industry is the best place for innovation in the health IT world. But he emphasized that government action was needed to make a more efficient marketplace.

"We need to do the minimum government action necessary, but no less," said Mostashari.

The hurdles for doctors and hospitals in adopting health information technology are high. Systems can cost millions of dollars, and it is often very difficult to get one company's system to communicate with another vendor's product. That means some of the most useful benefits of health IT, like having medical records follow patients as they move from doctor to doctor, are particularly challenging to accomplish, especially for small provider groups.

Former Senate Majority Leader Tom Daschle, who helped found the Bipartisan Policy Center after he stepped aside as President Obama's first nominee to head HHS, said this was the "most transformational time in this nation's history" for health care, in part thanks to health information technology.

"We have a health care marketplace and a collage of subsystems, which I believe has always called for great integration, greater collaboration," said Daschle. "And we have today a 21st-century operating room and a 19th-century administrative room. Health IT is the best way to bring that administrative room to the 21st century."

Former Sen. Robert Bennett, R-Utah, now a senior fellow at the center, said the marker of success in health IT will be lower costs and higher quality care. "I'm glad you're listening and holding meetings," Bennett said to Mostashari. "But those are your metrics.... If those things are not working, you're wasting your time and your money."

Bennett said it was "crazy" to not support health IT, but raised concerns about the confidentiality of patient information.

Mostashari said the agency was taking small steps to get there first, in order to protect patient security. "We start with what we can do today. We start with simpler exchanges," he said.

One simple step, said Mostashari, would be making it possible for doctors to electronically send health records, instead of printing an electronic health record and faxing it to another provider.

"The paper world is no panacea for privacy and security, either," said Mostashari.

When asked if the federal government would give providers more money to encourage even more widespread adoption of health IT, all three men agreed that needed to happen.

"I think there has to be a day, because it's so logical. There has to be a day when we will take the bull by the horns and do that. I think we're creating a new environment for that to happen," said Daschle.

"I'm a Republican who does not believe all government spending in inherently evil," said Bennett, drawing a laugh from the crowd. "That's one of the reasons I'm no longer in the Senate. Amen."

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