My Issue: The issue that I am concerned about deals with Health Informational Technology or Health IT. This issue focuses on how the United States health system could be operating more efficiently and effectively if we are to change the current Health IT systems by implementation of an interoperable infrastructure that results in EMR (Electronic Medical Records). What is interoperability in Health IT?Interoperability is the ability to have a hospitals computer system connected with other hospital's systems so that the final outcome will be a nationwide network of Health IT systems connected to one another. Current Legislation:Representative Sam Johnson of Texas has already started this process to a more effective and efficient health system by introducing bill number H.R. 1309. This bill's title is to encourage and enhance the adoption of interoperable health information technology to improve health care quality, reduce medical errors, and increase the efficiency of care. It was introduced to the House on February 12, 2009.Who is affected by my issue?:Being that my issue is correlated with one of the largest cost expenditures in the United States it is surely to affect a number of people. The one's who will be affect the most by a change to Health IT would be doctors, patient, and health care providers.Gains: Affected the most by this issue would have to be the doctors. With interoperability doctors will have the power to access specific patient data that without interoperability would have possibly been locked in a database or put into hiding in a file drawer. Doctors like to have patient information at their fingertips whenever possible and having a network system that can simply connect a patients records directly to him/her would benefit the doctors accuracy on patients, overall work flow, and hospital recognition. The gains sort of connect like a chain, if you have the doctors benefiting from this Health IT system the next ones down are the patients that work with those doctors. The patients will have the acknowledgment that the doctor has the most up to date records and can administer him/her the best quality care possible. Eventually everything adds up to an efficient and reliable communication tool within the hospital. Doctors will be able to communicate better with their patients, other clinics, other doctors, and administrative staff on ways to further improve there infrastructure. The greatest gain is to the United States health system as a whole. With an update to interoperability systems, we can rely on there to be less flawed processes, more efficient work flow, and top of the line quality medical care. Loses: Those who many suffer the brunt edge of this transformation to interoperability infrastructure is a bit limited. The people and loses coming from interoperability systems can be somewhat questionable. If some doctors can not grasp the way the new Health IT system functions then it would cause them to lose the reliability of patients, patient information, downgrade in work flow, and the worst lose; their jobs. As for the patients, they may inquire loses with insurance companies if their companies gain hold on health records that can make all the difference in being qualified for health insurance, that's if insurance companies have the rights to access the same medical files that doctors can. However, I feel the greatest loss would be our health. An IT system like interoperability has the chance to advance the way the U.S. handles its health care by providing doctors with the information necessary to provide top notch quality care to those patients.Consequences:By improving the way technology is used in health care systems it doesn't seem like there should be any consequences to individuals, families or society but begin that technology is not always the most reliable tool we are bound to develop some repercussion with this issue. The consequences of interoperability IT to society would breach mainly the lines of confidentiality. Living in a world that is centered around technology and when things don't go as planned with technology people become impatient, upset, and blame it on the system not working. If there would happen to be a malfunction with the interoperability IT system it would cause much unsatisfactory with the new IT system, decrease patient satisfaction with there doctors, and a burden for families who are unhappy with the new IT. Issue's Economic Impact:If there is a nationwide push towards having an interoperability IT system then costs would be weighed upon the government which more than likely would be eventually paid for by tax payers dollars. However if we have certain hospitals designating that they are switching over to an interoperability system the cost would be weighed upon the administration. These costs are countered weight with the future benefit that will come from having an inter connected medical network. Economically this system would greatly benefit the consumer. Interoperability would allow individuals to access information about their health status, eliminate hesitation about switching between clinics now being that they will not have to fear about losing medical records, and benefit from the economic efficiency of less medical error, duplication of records, and increased work flow. Issue's Social Impact:The social impact of interoperability would fall upon the tax payers if the government were to make this a nationwide change to the Health IT system. This of course wouldn't be very fond by some while others will not mind and feel that overall wellness should not be decided by a price. Relating back to healthcare providers, this may also impact the group of people who are worried that their insurance providers may view records resulting in a denial for medical coverage and this includes all those who are trying or have been denied coverage that feel it is wrong to have medical records inter connected in a way that allows insurance companies a full detailed report of their medical history. However the social gaining impact will be that ever increase group of people who applaud the use of have medical records inter connected that allows for the most efficient, effective, and grade A doctors that will be able to provide them with the right care. This issue will have a positive impact on the groups of doctors who feel that with an interoperable system they will be able to complete their job better than before by simply having the right medical records in front of them with a click of the mouse. The Barriers:The barriers addressing this issue is that of safety for the patient. Having a system that connects every medical records in a network may results in some unexpected problems. Example, a doctor wants to bring up a medical records for Jane Doe. The doc pulls up her records to write out the correct medication prescription. However he did not notice that the record he pulled up was for a Jane E. Doe and thus providing her with the wrong a medication that she may possibly be allergic to. Because the electronic medical records will be entered in by name it will be possible to run into the slightest mix-up with identities. It seems simple to overcome this issue, the IT system will have to be upgraded as to where instead of locating the patient by name they may be located by say a phone number, or address, or even a specific patient number id. The mix up in identities with Jane Doe and Jane E. Doe may also cause there to be billing problems. If Jane Doe's insurance company is looking to bill her for the medication prescribed but by accident confused Jane Doe for Jane E. Doe, then there is going to be a conflicting with payments and result in administrative costs to resolve the error. These two barriers to the issue could be resolved in the same way. What are the resources?
I would have to say that the most important resource that may come into play on this issue is the Health Insurance Portability and Accountability Act or HIPPA. HIPPA aims to improve the effectiveness and efficiency of the health care system, portability and continuity of health insurance coverage in the group and individual markets, and to provide consequences to those that do not apply with the regulations stated within the act. As well to address this issue I will need up to date information about certain interoperability software being developed and how they expect each one to be a success. Most of my resources can been found with in depth internet searches, library references, and magazine articles. History of the Issue:This issue has been on the rise since 2005. The NHS (National Health Service) is hoping to have 60,000,000 patients with electronic medical records by 2010. The progression of switching to electronic medical records is increasing at a slow rate. This rate may be increasing very slowly due to the limited EMR systems that will be used to inter connect all records. In 2005, to push towards the production of EMR systems that will connect medical records within a networks the U.S. Department of Health and Human Services made a non-profit organization designated specifically to develop EMR systems called Certification Commission for Healthcare Information Technology (CCHIT). This new organization provided great results in 2006, CCHIT released a list of 20 certified EMR products. Allies & Opponents:Allies of this issue would be patients who are encourage by the benefits that interoperability will bring to health care quality, doctors, CCHIT, computer engineers installing these programs, software trainers, health insurance companies, and hospital administrators. Opponents of introducing an nationwide interoperability system would be tax payers, hospital administrators not interested in the costs, and health insurance companies that have to change their record systems. My Recommendation:I would recommend that my representative votes yes for bill H.R. 1309 to encourage and enhance the adoption of interoperable health information technology to improve health care quality, reduce medical errors, and increase the efficiency of care. Voting yes would result in a more efficient and effective medical system that allows doctors to provide the absolute best care they can deliver to the patient by having up-to-date medical records at the tips of there fingers.
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