New federal medical technology rules aren’t a ‘HIT’

Can health information technology transform the healthcare system? With an expansive, multi-year plan to digitally overhaul the nation’s medical records systems, the federal government is betting it can.

But doctors aren’t so sure. Most see value in digital recordkeeping. But many are also worried that the government’s efforts could undermine the doctor-patient relationship by forcing physicians to spend more time untangling Washington’s red tape — and less time treating the sick.

Few doubt that health information technology (HIT) has the potential to change American medicine forever. In the near future, according to the nonpartisan Congressional Budget Office, few savings will be realized. But in the long-term, digital records could make medical care smarter and more precise, and also less expensive. In fact, the RAND Corporation estimates that HIT combined with electronic information exchanges could generate $77 billion per year in healthcare savings.

But HIT could have some major drawbacks as well. Implemented poorly, it could undermine patient care by restricting the treatment options available to doctors, and tying up caregivers in red tape.

To see how HIT could go wrong, take a look at the increasingly popular practice of electronic prescribing.  On the one hand, this technology eliminates the need for scribbling on tiny prescription pads. No more losing your prescription form. No more pharmacists who can’t read the doctor’s handwriting.

Unfortunately, electronic prescription software doesn’t always play it straight. Software companies have design systems that restrict or influence a doctor’s choice of treatments by building in subtle rules and requirements.

These rules often make it tougher for doctors to customize care and give patients the best treatments available. Many fear that public insurance programs will start utilizing such systems.

Indeed, the Maryland Medical Association has already passed a resolution to ensure that electronic record systems don’t restrict the treatment options available to doctors. Other states need to follow suit. Otherwise, HIT could do more harm than good.

Moreover, the point of electronic recordkeeping is to reduce paperwork and facilitate information sharing. But greater access entails greater risk. For digital health records to work, designers have to safeguard the privacy of patients.

Unfortunately, previous efforts to implement HIT have too often done more harm than good. A recent study from Arizona State University’s W.P. Carey School of Business found that several HIT initiatives actually made health care more expensive and less effective.

And thus far, the federal government has failed to avoid similar mistakes.

In an attempt to encourage doctors to invest in the expensive process of switching to digital records, the federal government set up a system of subsidies to support doctors who make the transition.

However, there are strings attached to these subsidies. To get them, doctors have to meet a complicated set of federal dictates known as “meaningful use requirements.” The American Medical Association has warned that these rules are “too aggressive,” and could result in some physicians not participating in the subsidy program.

Specialists worry that these requirements will distract them from their core duties by making them spend too much time recording basic health measurements. In fact, according to a survey from the Medical Group Management Association, 68 percent of doctors expect to operate at reduced efficiency because of these rules.

The American Academy of Family Physicians has called the rules “unworkable, excessive, or redundant,” and concluded that they “will actually impede the very goals of the [HIT] legislation.”

Doctors are right to worry.

New technologies can streamline the healthcare process and dramatically improve patient care. But if the government attaches burdensome rules and regulations to these tools, patient care could actually get worse.

Health information technology may indeed fundamentally transform medicine for the better. But only if Washington makes rules that let it work.

Sally C. Pipes is President & CEO of the Pacific Research Institute. Her latest book, The Truth About Obamacare (Regnery 2010), was just published.

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