Medical Device Daily National Editor

During the rough-and-tumble presidential campaign, President-elect Barack Obama demonstrated his ability to sort through priorities, maintain focus on some key messages: the anti-McCain/Bush emphasis and "change we can believe in."

And as he prepares to take office he obviously will have to use that same ability to sort through an avalanche of advice and recommendations – from which is the best White House dog to the best strategies for salvaging our 401(k)s.

Among the vast mix of advice coming his way comes a recent offering from the Healthcare Information and Management Systems Society (HIMSS; Chicago), on advancing the use of health information technology (HIT).

The advice comes under two categories: "eliminating unnecessary or duplicative healthcare services and costs" and fostering "the use of health IT" (Medical Device Daily, Dec. 23, 2008). And it is pushing HIT as part of overall economic stimulus for the country, not just the benefits for healthcare.

Among the HIMSS recommendations:

To invest "a minimum" of $25 billion in the private sector category to assist hospitals and physician practices to adopt electronic medical records (EMRs). And "additional funding" should be provided to cover EMR adoption by federal and state-owned healthcare providers.

To convene a White House "summit" on healthcare reform through the use of IT, and authorize a federal HIT "advisory and coordinating body."

To apply recognized standards and certified HIT products among all federally funded health programs, and expand Stark Exemptions and anti-kickback safe harbors for EMRs to interoperability specifications that are Certification Commission for Healthcare Information Technology (CCHIT)-certified.

But will we see significant forward movement in HIT use, or only continued slow growth? Is there any support for these proposals? Or is HIMSS a lone voice?

Meredith Taylor, director of congressional relations for HIMSS, told Medical Device Daily that there is clearly more opportunity for real advances in HIT, given the current support from various sectors, and that HIMSS is just one of several voices urging expanded HIT.

"Definitely, what we're seeing is a sea change within congress, especially surrounding HIT."

And she said that indicators forecasting this support "were starting from the summer of 2008 to the fall of 2008. We saw many pieces of comprehensive health IT bills introduced in the house, and much attention by members of congress by outside stakeholders."

Among those she noted is a proposal for developing an electronic medical record system for children.

As an umbrella statement, she said that HIMSS is "well aware that healthcare reform is going to be a priority this year," with many of the proposed reform bills asking "to apply health IT awareness around importance and capabilities that HIT offers in the U.S."

And she expressed certainty that any economic stimulus package proposed by the Obama administration "will include HIT components – and so we're very optimistic. Many are recognizing the HIT role in economic stimulus."

Among the other voices supporting strong advances for HIT as economic stimulus is the Information Technology and Innovation Foundation (ITIF; Washington).

ITIF on Wednesday will be appearing at the National Press Club in Washington to unveil a new report, "The Digital Road to Recovery: A Stimulus Plan to Create Jobs, Boost Productivity and Revitalize America." Taylor told MDD that she has been invited to participate in a panel discussion on that report's recommendations.

ITIF says that the report provides an estimate of the "short-term impacts of spurring investment in three critical digital networks: broadband, the smart grid (making the electric distribution system intelligent) and HIT. And the report will outline policy steps to spur these kinds of investments.

Taylor said she could not report that there has been any response from the Obama administration to the HIMSS package of recommendations, but added: "I will say as we were developing these, congressional staff was awaiting our recommendations and very eager to receive our recommendations."

She said that one of the next steps will be for HIMSS "to meet with congressional staff, to educate them about the reasoning behind the recommendations. In addition, we plan to hold an educational session for staff on the recommendations."

She emphasized that the recommendations should have some force, since they represent a broad consensus, reflecting the organization's 20,000 membership roster and "over 100 volunteers participating and developing these recommendations."

The volunteers deliberated over four months as the HIMSS Healthcare Transformation through Health IT Workgroup.

The effort to influence federal action on HIT is, of course, a top-down effort.

In terms of bottom-up challenges, Taylor acknowledged the barrier presented by the great many vendors in the electronic medical record sector. But she said that the wealth of vendors and product "choices" can be overcome by an emphasis on shared and agreed-upon standards.

"More and more states, through the federal government," Taylor said, "are referencing and applying CCHIT-certified products in various initiatives. Virginia is one of those states, requiring that any public funding for HIT is for CCHIT-certified products."

She could add to the list of state supporters New York Gov. David Paterson, who last week in a letter to Obama called for funding of the state's infrastructure projects, including a federal investment of $20 billion to support a variety of HIT projects.

The letter reads, in part: "With seven health IT projects that are ready to go, New York estimates that we are ready to obligate in excess of $300 million within 180 days to implement a plan for health information exchange and $1 billion for provider electronic health records. A national investment of $20 billion is necessary to implement qualified statewide programs and to promote the adoption of electronic health records by physicians and hospitals."