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Obama e-health plan: Health IT leaders weigh in

By Lucas Mearian, Computerworld
February 26, 2009 06:20 PM ET

Computerworld - President Obama, in his joint speech to Congress this week, emphasized that he wants electronic health records to be established for all Americans over the next five years. His recently passed American Recovery and Reinvestment Act earmarked US$19 billion for health information technology spending, $17 billion of which is designated for incentive payments for Electronic Health Record use beginning in 2011. To date, only about 25% of the nation's 5,000 hospitals have rolled out electronic health records systems, and only a small fraction of physician practices have done the same.

The EHR funds will be controlled by the U.S. secretary of Health and Human Services (HHS), which has discretionary use over US$2 billion of the funds.

The legislation also allocates, among other things, $85 million for health technology investments to the Indian Health Service, $1.5 billion for Community Health Centers and $50 million to HHS to improve its technology security.

Computerworld spoke with three health technology experts from private corporations and the IT vendor side to get their take on the new bill and whether the billions being spent will succeed in establishing EHRs.

The three experts are:

Dr. Charles Kennedy, senior vice president for Health IT at Indianapolis-based WellPoint Inc., the country's largest health benefits provider. WellPoint provides health coverage to about 34 million members through its subsidiaries, primarily under the Blue Cross and Blue Shield name. Kennedy is a founding member of the Certification Commission for Healthcare Information Technology and a board member of the National eHealth Collaborative.

Frances Dare, director of the health-care consulting practice for the Cisco Internet Business Solutions Group. Dare recently testified on Capitol Hill and has advised the Obama administration regarding the stimulus package. She has spent more than 25 years in the health-care industry as a hospital administrator for two facilities.

Phil Fasano, CIO at Oakland, Calif.-based Kaiser Permanente, a $38 billion nonprofit health-care system. Kaiser Permanente offers health care services through a network of nearly 14,000 physicians at Permanente Medical Groups; 32 medical centers and more than 400 medical offices that form the Kaiser Foundation Hospitals; and the Kaiser Foundation Health Plan, which has 8.7 million members. Kaiser is finishing up a 5-year EHR system implementation that cost $5 billion and created 5 petabytes of data on spinning disk serving 32 hospitals, more than 400 medical clinics and 14,000 physicians.

The following is an edited version of those interviews.

How will the billions of dollars help spur adoption, particularly when you consider many small hospitals and physician practices have not even begun an EHR rollout?

Kennedy: Well, that's where the challenge is. If you look at the penetration of [electronic medical records], they're highest where there's enough of a facility there to be able to support the infrastructure costs. When you look at solo and small physician groups, which still represent the majority of how physicians practice, we are going to have to take advantage of the inherent scalability of the Internet as well as some of the existing infrastructure.

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