Health IT has been one of the few areas of bipartisan agreement in recent years, observed Health and Human Services Secretary Kathleen Sebelius in her keynote address Wednesday at the HIMSS conference in Orlando. She's right about the history. For example, former President George W. Bush launched the federal government's campaign to increase EHR adoption in 2004, and both former HHS chief Mike Leavitt and ex-Senator Majority Leader Bill Frist have been strong supporters of the technology.
But the hyper-partisan warfare over the budget deficit has produced some dissonant notes in that picture of harmony. For example, the recently introduced bill to take back some of the money allocated for meaningful use incentives is not likely to pass, but it shows that some Republicans don't give a hoot about health IT. The GOP catcalling over President Obama's proposed "investments" in the economy also calls into question the future of federal efforts to promote information technology.
So it was no accident that Sebelius focused partly on the role of health IT in driving innovation and adding jobs. "We believe in health IT because it's an investment in a stronger economy," she said. "Health IT is one our most promising new frontiers. There are 231 companies that have certified EHR products, and two-thirds of those have 50 employees or less. Is the next Google in there?"
Sebelius also reiterated the importance of health IT in transforming healthcare--a theme that departing national health IT coordinator David Blumenthal elaborated on in his remarks following those of the HHS chief. But politics was never far below the surface in Sebelius' talk.
"The market for EHRs will be determined by how useful they are to providers, and that depends on healthcare reform," she maintained, noting that the reimbursement changes and new safety initiatives in the Affordable Care Act will increase demand for health IT.
In essence, what Sebelius was telling the HIMSS attendees was that if they wanted providers to adopt their products, they should support the reform law, which is under ferocious attack from Republicans. While information technology is a necessary tool for reform, reform is also essential to the spread of health IT.
You don't have to be a Democrat to see the logic in Sebelius' argument. The Affordable Care Act is taking the first steps to restructure our healthcare system. It encourages the formation of accountable care organizations, establishes a mechanism for comparative effectiveness research, and, above all, seeks to replace fee-for-service with pay-for-value. The prospect of those changes--as much as meaningful use--is what lies behind providers' new interest in health IT.
So everyone in this industry has a vested interest in the success of healthcare reform. If the Republicans succeed in repealing the ACA, meaningful use will still spur a lot of IT adoption, but the pace of change will be far slower. - Ken