Newt’s Vision
By Mertz, Kory
Former Speaker of the U.S. House of Representatives Newt Gingrich is a frequent commenter on health IT issues. He is founder of the Center for Health Transformation, which seeks to create system wide transformation of health care. Gingrich will be speaking at NCSL’s 2008 Legislative Summit on July 24 in New Orleans. Q. The U.S. health care sector is one of the last to be transformed by information technology. Why do you think this is?
A. There are many obstacles blocking progress, from the vast decentralization of the industry to payment models. Two of the biggest obstacles are governmental regulations and a lack of interoperability standards for data exchange.
Take Stark and Anti-Kickback laws. They were designed to protect patients and health systems from criminal providers and suppliers by prohibiting physicians from referring their patients to healthcare centers with which they have a “financial relationship.” That’s certainly necessary, but they have the unintended consequences of preventing hospitals and health systems from sharing with physicians their health information technology systems, particularly electronic health records. Granted, there has been movement on this front with HHS (Health and Human Services) opening some exemptions for IT, but they did not go far enough.
Another obstacle to overcome is the lack of interoperability standards for data exchange. Although more physicians’ offices and hospitals have modernized their own healthcare delivery systems, they have built customized silos with individual data standards that are virtually unrecognizable to outside systems.
Q. What will have to happen before health IT is widely adopted?
A. Before the United States can modernize its care delivery process through HIT, we must start with rooting out waste and inefficiencies by fundamentally changing the way we pay for the delivery of care. We need to move from a transaction-based model to a quality-or outcomes-based model. This will not only eliminate the financial incentive to use tests, treatments or therapies that are not directly beneficial to the patient or the care process, but it will have second-order effects of driving the adoption of tools and techniques that will produce better outcomes, such as electronic health records, electronic prescribing, and adherence to clinical guidelines/best practices.
Q. What role do you see for government in advancing health IT? What sorts of things should government not do?
A. Healthcare consumes 26 percent of all federal spending and growing, while the looming retirement of the Baby Boomers and their entrance into Medicare will call for critical choices by the federal government. Health IT has to be part of the solution, and the Congress can play a role. They can pass legislation that:
1. Drives adoption of health information technology and spells out the federal government’s role in developing interoperability standards, including deadlines for action;
2. Provides meaningful grants or an innovative loan program to spur adoption, in the absence of comprehensive payment reform;
3. Creates clear, concise, and straightforward exemptions to Stark and Anti-kickback statutes so that hospital systems and other entities can choose to provide community physicians with health information technology, particularly electronic health records.
Q. What role do you think states should play in advancing health IT?
A. States can play a vital role in advancing HIT initiatives. In 2007, Minnesota passed legislation that mandated all hospitals and healthcare providers to adopt interoperable or interconnected systems by 2015. The state, through the Minnesota e-Health Initiative in the Department of Health, is working closely with representatives from every sector of healthcare to meet this bold deadline. In addition, the state of Georgia made important strides last year when the General Assembly passed and Governor Perdue signed legislation that allows physicians to use and pharmacists to accept electronic prescriptions. Tennessee, Florida, Massachusetts and many others are playing an enormous role in advancing health IT.
Q. Do you think that health IT will live up to the claims that it will greatly improve quality and produce some $77 billion per year in savings in health care?
A. Health IT will exceed these expectations. Every time information technology replaces manual processes, it is more efficient, safer and less expensive overall. Hospitals and health systems are seeing results all across the country. After The Health Alliance Plan and Henry Ford Health System in southeastern Michigan partnered with the Big Three automakers to implement electronic prescribing in the region, the technology electronically caught more than 85,000 prescriptions that generated drug-interaction or allergenic alerts. According to the Henry Ford Health System, the $1 million start-up investment generated a $3.1 million savings, primarily due to increased generic drug utilization. States like Tennessee are also making strides, deploying to every Medicaid beneficiary an electronic health record filled with their personalized medical history. Tennessee officials project that for every $1 spent on the new technology in its first years of operation, the state will save $3 to $4.
Q. What do you think health IT will look like 10 years from now?
A. We at the Center for Health Transformation strive for a 21st century intelligent health system-a fully interoperable, consumer- centered health system that saves lives and saves money for all Americans…. (National, interconnected) electronic prescribing, computerized physician order entry, electronic health records, decision support tools and barcoding will all become imperative technological tools used in the care process that will allow for the connectivity, efficiency and improvement we all aspire to achieve in the future.
Kory Mertz, NCSL’s health information technology expert, conducted this interview.
Copyright National Conference of State Legislatures Jun 2008
(c) 2008 State Legislatures. Provided by ProQuest Information and Learning. All rights Reserved.