Obama advocates electronic health record with stimulus funding

"Our recovery plan will invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy, and save lives."

- President Obama in his Feb. 24, 2009 speech to the joint session of Congress

President Obama waves after his address
to a joint session of Congress, Tuesday,
Feb. 24, 2009. (AP Photo/Pablo Martinez
Monsivais, Pool)

As far back as 2005, you heard Hillary Clinton talk about it. You heard Newt Gingrich talk about it. Barack Obama, as senator, cosponsored legislation advocating electronic health records, along with then Senate Majority Leader Bill Frist (R-TN).

But it took the American Recovery and Reinvestment Act (aka the "stimulus") to create the mechanism and funding to make it a reality. According to a letter to members, Don Detmer, MD, president and CEO of the American Medical Informatics Association, a leading medical information technology group, said the stimulus makes available "some $19.2 billion intended to support widespread deployment and utilization of health information technologies (HIT) and the availability of an electronic health record (EHR) for all citizens by 2014."
 

So what exactly is an "electronic health record?" The National Institutes of Health (NIH), in a 2006 document sparsely entitled "Electronic Health Records Overview," uses the following definition, established by the Health Information Management Systems Society (HIMSS):

"The Electronic Health Record (EHR) is a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The EHR automates and streamlines the clinician's workflow. The EHR has the ability to generate a complete record of a clinical patient encounter - as well as supporting other care-related activities directly or indirectly via interface - including evidence-based decision support, quality management, and outcomes reporting."

 Besides providing funding for EHR development and implementation, HR1 also seeks to demonstrate that the data can be protected "with the goal of minimizing the reluctance of patients to seek care (or disclose information
about a condition) because of privacy concerns." (Sec. 3002-b-2-B-i)

When President Obama spoke Tuesday night about EHR bringing down health care costs, he also meant that he would encourage physicians to become "meaningful users" by reducing the Medicare fees HHS pays to physicians by up to five percent.

"Meaningful use," as HR1 describes it (under Title IV, Subtitle A), includes reporting for one year on the use of EHR, using the technology for e-prescriptions, and "information exchange."

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