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HHS Promotes Electronic Medical Records

Kate Traynor

The Department of Health and Human Services (HHS) yesterday released a report outlining a framework for the widespread adoption of electronic health records.

At a press conference yesterday in Washington, D.C., HHS Secretary Tommy G. Thompson said the report describes "a vision for health information technology in America."

"We see patients with records that are always current and always available so that services are not duplicated," Thompson said. "We see systems where records are clear and are accurate and legible so that medical errors are avoided. We see electronic health record systems that don't just provide the patient's records, they also give the doctor the access to the treatment information he or she needs for that particular patient. We see decision support for health professionals as they care for patients. Today, we don't have these features in the practice of medicine."

The report was created in response to an April 30 executive order calling for the development of "a nationwide interoperable health information technology infrastructure." The executive order required Thompson to install a "National Health Information Technology Coordinator" within HHS to move the electronic medical record initiative forward.

David J. Brailer, who was named to the position of National Coordinator, said the report "is not a full-blown strategic plan" but is instead a "general approach" designed to "stimulate a dialogue" on how to move toward an electronic health record system within 10 years.

"We leave a lot open, because we're trying to let the private sector and our agencies fill in so we can all move together towards this goal," Brailer said.

The report outlines 12 strategies to meet four overall goals, which are to:

"Inform Clinical Practice" by providing incentives for physicians to pursue electronic records systems and minimize the financial risks for those who adopt the systems,

"Interconnect Clinicians" by designing records systems that are portable between practice settings,

"Personalize Care" so consumers can become more actively involved in health care decisions, and

"Improve Population Health" through the collection and monitoring of health data among public health officials, clinical researchers, and clinicians.

In a statement, Thompson said HHS is creating a Health Information Technology Leadership Panel composed of "executives and leaders" who will report on cost and benefit issues central to the adoption of electronic medical records.

Thompson told reporters that the panel will release a report in October that describes "how we're going to do this and how we're going to pay for it."

A separate but related issue is the use of electronic prescribing, which the Centers for Medicare and Medicaid Services (CMS) is promoting in the wake of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

Thompson said CMS is required to establish rules for electronic prescribing by January 1, 2006, when the Medicare Part D prescription drug benefit takes effect. But Thompson said CMS will "accelerate its regulations for e-prescribing" and unveil them "much sooner" than the 2006 deadline.

CMS Administrator Mark McClellan said that support for electronic prescribing "will be mandatory for all drug plans participating in the Medicare Part D prescription drug benefit" but that physicians will not be forced to submit electronic prescriptions for Medicare beneficiaries.

McClellan said CMS is currently reviewing promising national models for electronic prescribing systems and plans to support pilot projects that will aid in the nationwide adoption of such systems.

"Promoting the adoption of e-prescribing is an essential step towards improving the quality of health care," McClellan said. "We'll be implementing the new Medicare drug benefit in a way that does all we can to help patients get the added benefits of e-prescribing as soon as possible."