Medical Device Daily Washington Editor
WASHINGTON – On Wednesday morning, two senators – one Democrat and the other a Republican – outlined their respective parties' healthcare agendas for the coming year. Though both lawmakers clearly differed in their prescriptions for healing the U.S. healthcare system, they shared a common theme: reforming healthcare information technology (IT).
"It is time to accelerate the IT revolution as it relates to healthcare," Sen. Ron Wyden (D-Oregon) told a gathering at the 2005 National Policy Forum for America's Health Insurance Plans (Washington). Wyden is active in the Senate on healthcare issues.
Calling current efforts "fragmented and haphazard," he said revolutionizing healthcare IT and paving the way toward the widespread adoption of electronic health records (EHRs), one of the three main healthcare goals of the Democrats in 2005.
"This is an opportunity for bipartisan cooperation," Wyden said.
"Almost daily, there is a new drug or device, but we are so far behind in the information technology for healthcare," said Senate Majority Leader Bill Frist (R-Tennessee), proving that interest in the topic does indeed cross party lines. "Other industries use IT to get rid of waste and ineffectiveness, but American healthcare has remained in the Stone Age. This sector must make information technology a priority"
As a cardiovascular surgeon before being elected to the Senate in 1994, the 53-year-old Frist said he was used to rapidly changing medical technology, but was "constantly amazed" by how hard it was to do something as transfer patient information and diagnostic images to consulting physicians or healthcare facilities "just across the street."
He said improved healthcare IT would reduce costs by making the system more efficient, and would save lives and money by reducing medical errors through better tracking of a patient's medical records, their allergies, and other conditions. At one point, the majority leader said, "some have estimated" that such a system could save 20% of total spending on U.S. healthcare, though he did not attribute a source for the estimate.
According to the Government Accountability Office (GAO), $1.8 trillion dollars is spent annually on healthcare in the U.S.
"You can access your banking information from anywhere in the world with an ATM card," he said. "Similar technology could be used, for example, by emergency personnel after a car accident to save critical time and lives."
Frist, who already is being mentioned as a possible Republican candidate for president in 2008, is a member of the Senate Health, Education, Labor and Pensions Committee. "Americans should have access to a secure electronic medical record," he said, calling President George Bush's goal to have a workable EHR system in place in 10 years "achievable."
Wyden called the de-funding of the office of the National Coordinator for Health Information Technology David Brailer in the last budget cycle "a huge mistake" that he hopes is corrected in the upcoming budget. He said he was encouraged by the interest of Mike Leavitt, the new head of the Department of Health and Human Services (HHS).
He said Leavitt has expressed some "interesting and positive" ideas on the topic. During his confirmation hearings earlier this year, Leavitt mentioned having sought out Brailer to learn more about the government's efforts in creating a network capable of supporting a system of EHRs.
Wyden said creating uniformity for healthcare IT technology should be a priority. Frist echoed his colleague's comments, saying that the government and Brailer's office should work toward a set of standards that healthcare IT systems and facilities could turn to, which would ensure commonality and reduce the cost of trial-and-error software and hardware purchases.
"We can have a system that is private, protected, and secure," he added.
In the area of overall healthcare overhaul, Wyden said – along with IT reform – Democrats will focus on protecting the poor's access to adequate healthcare options and advocating for seniors, which would include reworking the current Medicare prescription drug program.
"That program is headed into extremely troubled waters," he said. "There is a real danger that an enormous amount of government money will be spent on a small amount of people."
Wyden recently introduced legislation he co-authored with Sen. Olympia Snowe (R-Maine) called the Medicare Enhancement for Needed Drugs Act, or MEND, which is intended to strengthen the drug coverage offered to seniors under the 2003 Medicare prescription drug benefit.
He said MEND addresses increasing drug costs by giving HHS the authority to negotiate lower prices for drug purchases through Medicare, and requiring ongoing information about savings in various plans and the prices of prescription drugs across multiple markets. The act also would have the GAO track and monitor drug prices, and review pricing of drugs used by most seniors.
According to Wyden, that is designed to ensure that pharmaceutical companies do not arbitrarily increase drug prices as the Medicare drug benefit takes effect. A recent Wall Street Journal report suggested that a sharp spike in some drug prices in recent weeks may be partly due to anticipation of the upcoming drug benefit.
Wyden, along with Sen. Orrin Hatch (R-Utah), last month introduced the Citizens Working Group on Healthcare, part of healthcare reform legislation passed in 2003. The group will organize local discussion to tell people how healthcare dollars are being spent annually and to get feedback on how the system should be changed.
The group will then report to Congress.
"I pushed for this legislation because for decades, from President Truman to President Clinton, healthcare reform has been pushed on the American people from inside the beltway [in Washington]," Wyden said. "Legislation was written in Washington, and people think under the influence of special interest groups. This goes 180 degrees in the other direction by starting outside the beltway with a public process."
He said he thinks people will be "pretty surprised" by the outcome.
More along party lines, Frist said the first fix that Republicans would look for is tort reform to limit frivolous lawsuits. "The cost from these lawsuits get passed on directly to hard-working Americans," he said. "Doctors can afford or choose not to practice because of the rising insurance costs, especially in trauma care."
He also said the fear of litigation forces doctors to perform defensive medicine, often performing unnecessary procedures or tests to lessen the likelihood of being sued, which also raises costs unnecessarily.
In addition, Frist touched on healthcare savings accounts and health plans to help small business provide healthcare for their employees.
"Republicans will say trial lawyers are to blame, and Democrats will blame insurance companies," Wyden said. "The real point is that there's plenty of room for improvement."