Driving In Traffic

Having always been a person with opinions on how things can and should be done, I love to harrass my state representatives and congress people. Just last week, I cruised on over to my local representative’s, Phil Gingrey, webpage to make sure he was working (rather than eating free lunches off of lobbists).

I was delighted to see that he recently appeared (April 6th) before the House Committee on Small Business, Subcommitte on Regulatory Reform and Oversight to talk about the implementation of electronic medical records (EMR) and other Health IT in small to medium size medical practices. Click here to see a transcript of his remarks.

Rep. Gingrey’s address was to introduce his new legislation, H.R. 4641 or the ADOPT HIT Act, that seeks to help physicians implement health information technologies into their practice by offering tax incentives. Those tax incentives include:

Now, I’ve been reading a bit on RHIO’s and how the Department of Health and Human Services is awarding contracts to set up Nationwide Health Information Network. Additionally, I remember that a couple of years ago, President Bush mentioned that he was going to push the implementation of EMRs as a part of a whole plan to help control the rising costs of healthcare. He reasserted this again in the latest State of the Union Address. The Executive Summary of the plan emphasizes a vision for “Consumer-centric and Information-rich care.” So now with Rep. Gingrey’s ADOPT HIT initiative, it would seem as if we are well on our way to moving toward the goals set forth by President Bush in 2004.

Now, I’m not arguing the value of this endeavor. As an administrator, I wholeheartedly agree that this is all good in theory and given the data to date that it has a real chance of improving the delivery of healthcare. However, I believe that the average doctor with a small to medium practice feels somewhat immune to this intiative for developing a nationwide network of health information. I wonder if many health service providers are aware of how their lives are going to dramatically change if Rep. Gingrey’s ADOPT HIT legislation passes and actually manages to encourage the adoption of EMRs. At the very least for the average physician/provider, that change means making friends with Mr. Computer or hiring someone to do it.

Now I admit, there are some physicians that are quick adopters. However, I just don’t see the average physician or small to medium practice relishing the idea of spending money on EMRs, learning how to use them and changing the operation of his practice. We all are creatures of habit and it is a difficult sell unless you can really spell out personally relevant ways that it will improve the care of a person’s specific caseload.

Things may go well as long as this is voluntary for the practitioners. However, given the ever-expanding role of the government in the delivery of healthcare, renewed rumblings for a universal healthcare model in the US and my read of the plan, this is setting up to be mandatory in the future. So really, in essense these are just the first steps toward being a full-blown government regulation– complete with its own regulatory office at USDHHS.

While I don’t really want to sound like I’m playing the role of a canary in the coal mine, but Rep. Gingrey’s legislation may be a first step toward “Borg-like” assimilation where “resistance is futile”. My fear is, like many providers were dragged “kicking and screaming” into managed care era, that providers will dig in their heels at the 11th hour on this too. I may be wrong, but I just hate to see a fight brewing when there is time to build a consensus.

Update (April 20,2006): Mike Ryan has written an article over at the Medical Blog Network that is worth taking a look at that reports that consumers and now Dr. David Brailer are having second thoughts about this.

Technorati tags: Health IT, Phil Gingrey, Electronic Medical Records, Electronic Health Records