Bush unveils national health care IT plan

U.S. President George W. Bush Monday unveiled a national health care IT plan focused on the development of personal electronic medical records for every American within 10 years and the appointment of a sub-Cabinet-level health care IT czar to oversee the process.

In a speech to the American Association of Community Colleges annual convention in Minneapolis, Bush called the current paper-based U.S. medical record system antiquated and said "medicine ought to be using modern technologies in order to better share information, in order to reduce medical errors, in order to reduce cost to our health care system by billions of dollars."

Bush added that "to protect patients and improve care and reduce cost, we need a system where everyone has their own personal electronic medical record that they control and they can give a doctor when they need to." Bush initially called for development of electronic medical records in his State of the Union address in January.

Lynne Royer, director of medical informatics at Community Health Network in Indianapolis, which operates five hospitals in Indiana, said Bush's speech and plan provides high-level leadership for change in an industry that has "done the same things in the same way for too long a time."

The White House said in a background briefing paper that the adoption of standards is key to development of a portable, electronic medical record. Last July, the U.S. Department of Health and Human Services (HHS) kicked off a program to provide a standardized clinical terminology database to health care organizations nationwide. That database will serve as one of the building blocks of a electronic medical record.

Standards will enable transmission of X-rays over the Internet, aid transmission of electronic lab results and lead to the development of electronic prescriptions, the White House briefing paper said.

James Mormann, CIO of the Des Moines-based Iowa Health System, agreed that standards are "absolutely" essential to development of a national electronic medical record system since health care professionals and providers today cannot even agree on the definition of an electronic medical record.

Standards are also essential for portability, Mormann said. Iowa Health has done about 70 percent of the work needed to deploy electronic medical records in its 10 hospitals. But that won't help patients who move to another state and check into another hospital that uses a different system from a different vendor, he said.

Royer cautioned that while developing an electronic medical record, the government and the industry need to view technology as a means to an end and not the end in itself. Besides applying technology to medical records, the health care industry also needs to build in workflow process change -- otherwise the industry could end up simply automating a "paper process which is a mess," Royer said.

Development of a standards-based national electronic medical record will not be easy or cheap, Mormann said. But "it is long overdue."

Scott Wallace, president and CEO of the National Alliance for Health Information Technology in Chicago, agreed, calling the project "as complex an undertaking as sending a man to the moon."

An HHS spokesman said the appointment of the new health care IT czar is expected within days, but no additional details were available.

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