And we're standing in our own way—rules and regulations just haven't kept pace with technology. The best illustration: The FDA governs medical devices, tools, and applications that rely on wireless communication. But general purpose communications devices such as smart phones fall under the jurisdiction of the FCC. So what about smart phones with decision-support apps? The FCC and the FDA have to work together to sort that out, the report says.
Credentialing and privileging standards are another example. Hospitals cannot grant privileges based on the decision of another hospital. So any physician who would conduct video diagnosis such as the one in the example above would have to be vetted first. It's expensive. And the irony is that hospitals that most need help from remote specialists probably lack the expertise to privilege them. It's also a burden on remote physicians to maintain privileges at a number of organizations. All of this further limiting the pool of experts available to the hospitals that need them.
E-prescribing is also tangled up in red tape, including the ban on e-prescribing controlled substances. The Drug Enforcement Agency (DEA) required doctors to keep two sets of records—paper and fax. "The complexity of dual systems is a best an inconvenience and at worst an impediment to adoption," the report states.
The FCC's recommendation: Congress, states, and CMS should consider reducing regulatory barriers that inhibit adoption of health IT solutions. The FCC and the Food and Drug Administration (FDA) should clarify regulatory requirements and the approval process for converged communications and health care devices.
For a government agency, you have to admit that the FCC's recommendations aren't half bad. But making it all happen is a whole different story. Just take a look at the alphabet soup of government agencies cited in the report. FCC, HHS, CMS, FDA, ONC—even, for goodness' sake, the DEA. Not to mention Congress.
It's going to require a lot of communication, cooperation, and hard work—as well as buy-in from providers and other stakeholders—before broadband and e-health can even come close to saving healthcare.