Health Care :: Adoption of health information technology will lead to higher standard of quality care

The benefits of full-scale adoption of health information technology (HIT) will be significant, leading to a higher standard of quality in the U.S. health care system, Lynne M. Kirk, MD, FACP, president of the American College of Physicians (ACP), today told a hearing of the Subcommittee on Regulations, Healthcare and Trade of the House Committee on Small Business.

“Congress has an important role in promoting HIT adoption and providing the necessary initial and ongoing funding mechanisms to assist physicians in solo and small practices,” Dr. Kirk emphasized. “Unfortunately, without adequate financial incentives, solo and small physician practices and their patients will be left behind the technological curve.”

Dr. Kirk, a general internist and Associate Dean for Graduate Medical Education at the University of Texas Southwestern Medical Center in Dallas, was one of five health-care panelists who addressed “The Value of Health IT to Solo and Small Practices” hearing.

“Depending on the size of the practice and its applications, acquisition costs on average $44,000 per physician. The average annual ongoing costs are about $8,500 per physician,” Dr. Kirk pointed out. “The ?business case? does not exist to make this kind of capital investment.”

Therefore, she noted, ACP strongly believes that to stimulate HIT adoption, reimbursement policies must be changed to support the investment in technology ? which should include sharing in system-wide savings attributable to their use of HIT and participation in quality improvement programs.

First, the College recommends Congress build into the Medicare physician payment system an add-on code for all office visits and other services. The amount of the add-on should relate to the complexity of HIT adopted by the practice.

Secondly, Congress should allocate the necessary funding for solo and small practices to make the initial HIT investment to purchase the necessary hardware and software. The majority of bills that have been introduced in the last Congress included the option of grants, loans, tax credits, or a combination of the three.

HIT alone will not lead toward full recognition of the potential benefits that include improved quality and better outcomes. The use of HIT should be directly linked to the concept of organizing care around primary and principal care. This model, called the “patient-centered medical home,” is based on the premise that the best quality of care is provided not in episodic, illness-oriented care, but through patient centered care that emphasizes prevention and care coordination.

In the 109th Congress, a flurry of legislative proposals were introduced that tried to define the federal role in speeding the adoption of HIT. ACP was particularly supportive of the bipartisan bill, H.R. 747, the “National Health Information Incentive Act,” sponsored by Subcommittee Chairman Charles Gonzalez because it specifically targeted physicians in solo and small practices for which assistance could provide the most benefit. The Gonzalez legislation would have built into the Medicare physician payment system an add-on code for office visits ? a critical element to support HIT adoption. Under the Gonzalez bill, these fees would be triggered if the procedure or service was facilitated by HIT.

“To achieve immediate quality and healthcare savings through HIT,” Dr. Kirk concluded, “Congress must recognize the significant financial barriers for solo and small practices. It must offer creative solutions to stimulate adoption of HIT where most Americans receive health care ? in offices of 1-5 physicians.”

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