Lawmakers, Witnesses At House Hearing Cite High Costs, Patient Privacy As Concerns Regarding Health IT Adoption

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Article Date: 05 Aug 2008 - 7:00 PDT

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Lawmakers and witnesses at a House Committee on Small Business hearing on Thursday discussed various barriers, such as high costs and privacy concerns, to adopting health information technology services for small and private health care practitioners, CQ HealthBeat reports. Legislation (HR 6357) aimed at spurring the adoption of health IT, such as a nationwide electronic health records system to raise the quality of health care and reduce medical costs, currently is under review in the House.

Committee Chair Nydia Velazquez (D-N.Y.) said that implementing an EHR system could cost a physician more than $44,000, with additional costs to maintain the systems. Velazquez said, "For small health care providers with limited resources, these upfront costs are enough to break the bank." She said that "only a handful of solo practitioners" currently have EHR systems in their practices, compared with about 57% of larger care providers.

Velazquez noted that specialty care providers, such as psychiatrists, neurosurgeons and pediatricians, also might face problems with finding health IT systems and services specific to their practices and needs. Committee ranking member Steve Chabot (R-Ohio) said, "Health information technology is a complex issue," adding, "The decision to implement health information technology in a small medical practice is considered an act of courage by many physicians."

Lawmakers and witnesses during the hearing also called on the federal government to develop health IT standards aimed at avoiding interoperability issues, such as communication problems between physicians, laboratories and pharmacies with incompatible health IT programs. They also urged federal officials to establish incentive programs for physicians and others who switch to health IT and voiced objection to a recent recommendation by Congressional Budget Office Director Peter Orszag for a so-called "stick" approach to encourage wider adoption of EHR technology, in which providers would face negative consequences for failing to adopt health IT programs.

Other Testimony
Edward Gotlieb, a representative for the American Academy of Pediatrics, said that more than 60,000 pediatricians would be left out of an incentive program for health IT if it is implemented through Medicare because they receive their funds from Medicaid. Gotlieb noted that although the SCHIP program also would provide $200 million in grants for health IT adoption, the Bush administration has twice vetoed legislation that would have reauthorized and expanded the program. Gotlieb said, "The already inequitable system of funding programs for children will only be worsened," adding, "This is not a good investment in our future."

Robert Plovnick, director of the American Psychiatric Association's Department of Quality Improvement and Psychiatric Services, said that privacy concerns and safety of private medical data also are issues. He noted that many patients with mental illnesses -- 7%, according to HHS -- opt to forgo treatments because of privacy issues. Plovnick said a variety of technological solutions are available and should be implemented along with standards to ensure adequate information security (Parnass, CQ HealthBeat, 8/1).

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