Now that the presidential nominees have chosen their running mates, the buzz surrounding the upcoming election has intensified. As the three senators and the governor from Alaska enter the final leg of the race, I thought I'd take a look at how the contenders could impact the role technology plays in healthcare.
Their overall healthcare reform plans pretty much follow party lines. The Democratic nominee is promising healthcare for all and the creation of a National Health Insurance Exchange that will act as a watchdog group and help reform the private insurance market. The Republican nominee stresses the role of personal responsibility in reforming the healthcare system and emphasizes prevention and offers tax credits as an incentive to help people buy insurance.
Both candidates have a plan for wider adoption of healthcare information technology—though Barack Obama's plan is more detailed than John McCain's.
Obama says he would invest $10 billion a year over the next five years to move the U.S. healthcare system to broad adoption of standards-based electronic health information systems, including electronic health records. He will also phase in requirements for full implementation of health IT. Just as an aside, when Democratic vice presidential candidate Sen. Joe Biden was running for president, he proposed spending $1 billion per year on a similar plan. Obama also promises to appoint the nation's first chief technology officer who would coordinate the government's technology infrastructure, work on issues of transparency, and "employ technology and innovation to solve our nation's most pressing problems."
McCain's plan is a bit more vague. "We should promote the rapid deployment of 21st century information systems and technology that allows doctors to practice across state lines," according to his Web site. Experts say that addresses one of the biggest barriers affecting wider adoption of telemedicine. His running mate, Alaska Gov. Sarah Palin already has experience in that arena. Earlier this year, she introduced the Alaska Health Care Transparency Act, which aimed to increase access to healthcare in rural areas through telemedicine and telehealth.
Arguably, Obama is the more technologically savvy of the two presidential candidates, and recently used text messaging to let nearly three million people know that he had picked his running mate. Meanwhile, McCain has told the press he doesn't send e-mails and is still getting accustomed to using the Internet, according to a Miami Herald article that asks, "Does the next president need to be wired to gain the vote of the American people?" Still, both sides support investments in technology in order to make healthcare less expensive, safer, and more accessible, but how deep does that support go and will support really make a long-term difference?
As heartening as it is to see so much attention being placed on healthcare IT adoption, Christine Chang, an analyst for Datamonitor's Public Sector Technology points out, "The U.S. already has presidential support on healthcare IT adoption with President Bush's goal for most Americans to have an EHR by 2014. Government support is not the only barrier to IT adoption; healthcare providers have yet to fully embrace and understand technology and the solutions themselves could still be improved. The healthcare community has bi-partisan support for continued investment in IT, now it must focus on these other barriers to technology adoption," she writes.
And I agree, but I also think it's going to be just as important for the new president, whether he be Democrat or Republican, to put great emphasis on removing those barriers. I haven't seen either candidate go into great detail about how he would address interoperability issues or coordinate state and federal laws to support the wider adoption of EMR that both candidates promise. Harry Rhodes, director of practice leadership at the American Health Information Management Association, says those issues are among the list of priorities they are pushing for in this election, including more comprehensive information policies, database standards, compliance, electronic content records management, and consumer education. The group is also lobbying for the creation of a national health information exchange. Rhodes says AHIMA is pushing to develop standards to support HIE and to develop model HIE policies and procedures.
In an opinion piece for HIMSS, Ed Larson, an independent strategy consultant who tracks interoperability standards for the association says, "If we are correct in our assessment that the candidates of both parties will focus programs on slowing spending increases through new administrative and financial controls and incentives, and on reforming health insurance—albeit in dramatically different ways, then we should expect real and grim changes for healthcare IT policy. Neither party's program points to greater promotion of electronic health records or to a nationwide networking infrastructure."
While I think it's inevitable that technology will have a starring role in healthcare reform, I agree with Larson that we are still miles away from addressing the issues that would truly promote greater use of electronic health records or to a national health information exchange.