Hope for Obama’s healthcare IT plan
pharmafile | December 1, 2008 | News story | Sales and Marketing |Â Â US, hc, reformÂ
The election of Barack Obama has brought high expectations, with his "Change Can Happen" mantra signaling to many that a transformational and reforming administration is about to enter the White House. However, Obama's impact on US healthcare technology policy remains uncertain, and there is a risk that the improvements in healthcare IT may lose significance when up against bigger issues.
As his campaign demonstrated, Barack Obama is technologically savvy, using sites such as Facebook, LinkedIn and YouTube as an integral part of his election campaign. In addition, Obama gained election support from high profile players in the technology and social media industries, such as Google chief executive Eric Schmidt. Post-election, the use of social media has continued with the launch of change.gov, a website that focuses on the Presidential transition, and there have been appointments to the transition team that indicate the presidency will embrace technology every bit as much as the campaign did.
Despite this, it is unclear whether Obama's understanding of the power of technology will adequately filter into all the areas of domestic policy in which it could prove beneficial. Healthcare, a high profile issue in the election, has much to gain from an infusion of technology, but it is an industry that is resistant to change. The hope is that Obama's innovative use of technology will trickle down to his healthcare policy. As his platform stands today, however, his healthcare IT plan reflects a more traditional approach, and shows little of the innovation Obama has demonstrated so far. Obama plans to invest $10 billion a year over five years in healthcare IT, but this impressive sum of money will still not be enough. As overruns in the UK have demonstrated, more investment will likely be needed, and money by itself is not sufficient.
The US also needs a comprehensive approach to helping providers adopt technology, which Obama alludes to, but does not provide specific details. Doctors are notoriously set in their ways, but financial incentives, such as from Medicare, could help them change. Additionally, the roles of organisations like the American Health Information Community Successor (AHIC 2.0) and the Certification Commission for Healthcare Information Technology (CCHIT) will be re-examined. Privacy policies, further complicated by un-tested HIPAA regulations, must be addressed, and co-ordination between isolated state health information exchange initiatives should occur as well. Finally, innovative technologies like personal health records, telehealth, and posting quality indicators online to increase transparency should be encouraged.
While Obama's administration must support healthcare IT initiatives, it will also need to temper expectations. Healthcare investment in the US has accelerated over recent years and will continue to grow, driven by demographic trends and social expectations, combined with major technological and pharmaceutical developments However, even if the overall goal of reducing the rate of acceleration in healthcare costs rather than decrease spending is modest compared to previous aims, it is certain that the anticipated economic benefits will not be seen for many years, as the US healthcare system will take a long time to turn around.
There are also subtle contradictions between Obama's overall technology agenda and his healthcare IT agenda. At a macro-level, the technology agenda is part of a social movement, aiming to gain wider grassroots participation in the democratic process and using the ubiquitous social media channels as an enabler. In contrast, the healthcare IT agenda sees none of the spark of change and radicalism that exists in other parts of the policy agenda, and focuses much more on transactional systems like electronic health/patient records (EHR/EPR), process automation, and wider records management, which are the same clinical and administrative applications and infrastructure components that have been adopted by the healthcare industry for years.
However, the biggest danger to the healthcare IT reform is that it simply gets lost among the throng of other initiatives, with both time and money being diverted elsewhere. The Obama election campaign site lists many issues on which the incoming administration will focus, such as defense, the economy, and the environment, and there is a risk that healthcare, and specifically healthcare IT, will be further down the queue than other issues, and will suffer from this reduced focus and the reduced budget allocation that may well follow.
The Obama presidency needs to recognise that its technological vision for other parts of the economy needs to percolate into its healthcare IT agenda. Equally, the new administration needs to ensure that the benefits of the more traditional healthcare IT investments that have been suggested are driven through. There are significant benefits to be found in the application of IT to healthcare provision, but these will not be unlocked unless there is sufficient investment, sustained attention from policy makers, and proper support for the structural and policy changes that are necessary to unlock the benefits.
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