Obama and Healthcare IT

Could the ultimate success of newly sworn-in President Barack Obama be dependent on IT practices and some of the healthcare technology issues that we often discuss here at Insurance & Technology? Paul McDougall of InformationWeek says as much in his January 20 blog post, "IT Could Make Or Break Obama Presidency."From InformationWeek's Government IT Weblog: ---

More so than any other issue, Obama staked his presidential run on a promise to overhaul the nation's healthcare system and lower medical costs for individuals. He's got to deliver on this one.

Obama, the nation's first BlackBerry-wielding president, says himself that IT will be central to the effort. "The Obama plan will lower health care costs by $2,500 for a typical family by investing in health information technology, prevention, and care coordination," he states on his Web site.

Obama wants all Americans' healthcare records and related information digitized within five years. That will lower costs and create efficiencies by eliminating paperwork, facilitating on-demand patient information for the full spectrum of providers, and making fraud easier to spot. That's the thinking, at least.

Trouble is that the history of e-health initiatives is riddled with failure and unkept promises. Healthcare integration on a national scale, it turns out, is exceedingly complex given the vast web of stakeholders involved and the implications for service delivery, privacy, and compliance.

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I'm not sure that I agree with McDougall's initial premise-that, more so than any other issue, Obama ran on a promise to overhaul healthcare. It was/is a key issue, to be sure, but Obama will ultimately be judged more on his handling of the economic crisis and issues surrounding the current situation in Iraq.

McDougall's quick analysis of the current state of healthcare IT is spot on though. Healthcare integration on a national scale is exceedingly complex. In the end, investing in healthcare IT may not be as important as coordinating how those investment dollars are used. That's because it is very unlikely -- with the number of different sizes and types of healthcare providers and payers -- that there is a one-size-fits-all solution for healthcare record-keeping.

As such, any government effort to digitize records within five years must start by answering these questions: What standards will be used to ensure that individual e-Health record systems can communicate with one another? and How can current personal health record (PHR) offerings made available by insurers and others be leveraged as part of this process?

Of course, those are not simple questions to answer. But, even before then-Senator Obama made healthcare IT a national issue, I was seeing progress in these areas. In my opinion, the insurance industry-with its extremely valuable and useful claims data-is the key part of this puzzle and many carriers are working with America's Health Insurance Plans (AHIP) to develop PHR standards. Further, some carriers are beginning to put such standards to use, as evidenced by Aetna's partnership with Micrsosoft's HealthVault platform.

Government involvement could help take this to the next level, perhaps developing a stronger critical mass around PHR and other e-Health record standards for interoperability. Of course, it's equally likely that government involvement will grind progress to a halt. Let's hope for the former.Obama wants all Americans' healthcare records and related information digitized within five years. That will lower costs and create efficiencies by eliminating paperwork, facilitating on-demand patient information for the full spectrum of providers, and making fraud easier to spot. That's the thinking, at least.