As the Department of Veterans Affairs evacuated hundreds of patients from its New Orleans hospital three days before the levees failed, another crucial part of the federal government's relief effort was air-lifted to Houston: two backup computer tapes holding more than 180,000 electronic health records.
The tapes included veterans' allergies, medicines and basic information -- enough data that any evacuated veteran could be treated at any veterans hospital. Without electronic records, hospital staff would have spent critical minutes, even hours, lugging thousands of paper files to higher ground.
This is what Rep. Jon Porter, a Nevada Republican and chairman of a key federal work force subcommittee, wants for the more than 8 million federal employees, retirees and their dependents who get health coverage through Uncle Sam.
At a hearing Wednesday on his proposal to bring this technology to the federal health insurance program, there was agreement among Republicans and Democrats that such advancement is needed and considerable discussion about how it should be achieved.
"The federal work force is an appropriate guinea pig to experiment on -- if, in fact, you have willing guinea pigs," said Del. Eleanor Holmes Norton of the District of Columbia. "Do not consider putting everyone in [this program] and telling them you have got to opt out of it. Not when dealing with people's medical records. That's the thing people most fear, getting beyond their hospital or their doctor. ... Take a small pool of the willing, and test it on them."
Former House Speaker Newt Gingrich, who founded a health care think tank in 2003, was the featured panelist at the hearing. He agreed with Norton that a voluntary approach would work because the popularity of these programs has been proven.
"If we try to impose this on people, it will arouse all of the privacy advocates and all of the federal employee unions and slow us down so much," Gingrich said. "Put volunteers in phase one and incentivize the plans to encourage people to join. Workers will talk to each other, and in three or four years, you'll see participation in the high 90s [percent]. If that last group prefers paper and wants to risk dying, that's their prerogative."
Porter's bill, the Federal Family Health Information Technology Act, phases in computerized records, which supporters say reduce medical errors.
Health plans, such as CareFirst BlueCross BlueShield, would be required to create an electronic record for each client. Next, they would open that record to enrollees, allowing them to add health history, diet, exercise and other personal information. Labs and doctors using electronic systems then would link to it. Finally, the bill would provide money to encourage doctors to install systems in their offices.
Gingrich compared the electronic system to building highways and using e-tickets for airline travel.
The VA began setting up electronic health records in 1996 and has accomplished much of what Porter wants. However, about 1,000 veterans still are testing the software that allows them to access their electronic records, said Dr. Robert Kolodner, chief health informatics officer for the U.S. Veterans Health Administration, a division of the VA.
The department also has the added benefit of being a patient's insurer and doctor, eliminating a layer of bureaucracy.
"If you go into our facility in Washington or Baltimore, you won't see paper records," said Kolodner, who lives in Columbia. "We also don't have file rooms for X-rays. We keep all sorts of images electronically, and they are available on any of our computer desktops across the country."
Porter's bill has six co-sponsors. One member of Porter's committee expressed concern to Gingrich that Congress -- with the distractions of a war in Iraq and the cleanup of Hurricane Katrina -- lacks the "will" to get this done. Among the concerns are privacy and Porter's plan to use reserves from the Federal Employees Health Benefit Plan's administrative fees to pay for the startup.
"Even some of the private-sector carriers ... have questions of liability," Norton said. "They don't necessarily want the responsibility of securing medical data on members of Congress, on people with high-level security clearances, on people whose identity is not even supposed to be known."
Health care costs
Plans by the Department of Defense to raise health care co-pays and prescription fees for its retirees under age 65 likely will not win approval from Congress this year, an influential senator told CongressDaily this week.
After a hearing on military benefits, Republican Sen. Lindsey Graham of South Carolina, chairman of the Senate Armed Services Personnel Subcommittee, said, "There is no way a 115 percent increase in co-pays and enrollment fees [in the TRICARE health insurance program] is going to happen in the next two years," according to the publication.
The fees and deductibles have not changed since 1995. As a result, health care costs eat up more of the Defense Department's budget each year.
Graham told CongressDaily that some "small bump-ups" in prices are on the table, but steeper increases would be delayed until independent analysts recommend ways to curb the growing costs of the program.
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