Washington Watch: Healthcare Integration

Health-Care Integration May Be an Expensive Prescription

Hospitals, doctors’ offices and insurance companies would have seven years to develop systems for sharing administrative and patient data, according to a bill proposed by Sen. Edward Kennedy (D-Mass.). But experts in health-care IT are leery of backing the measure without more proof of its ROI.

Kennedy says his Efficiency in Health Care Act would save time and money by giving patients, health-care practitioners and insurers access to treatment information within two days of a doctor visit. It would improve patient safety by requiring health-care facilities that treat at least 20,000 patients a year to deploy computerized physician order entry systems to record prescriptions and other doctors’ orders.

In a June speech, Kennedy said modernizing administrative systems, as he suggests, would reduce the cost of transactions processed by hospitals to less than a penny. But CIOs in the health-care industry foresee expensive system implementations.

Health-care companies have already begun to tackle some aspects of computerizing patient records. According to the American Society of Health-System Pharmacists, 4 percent of hospitals had deployed physician order entry systems in 2001. They have little incentive to pursue the industrywide integration that Kennedy calls for. “There’s great societal value,” says John Glaser, vice president and CIO of Partners HealthCare System in Boston, because health-care information would be more accurate and doctors would be able to spend less time on mundane administrative tasks. But the financial ROI isn’t clear. To provide a monetary incentive, the measure calls for up to $250 million a year through 2007 to subsidize the projects.

Sam Karp, CIO of the California HealthCare Foundation in Oakland, a nonprofit health-care research group, says the money Kennedy proposes wouldn’t cover much of the expense. He doubts CIOs would want to make integration with trading partners?necessary to give insurers the latest claims information?a big priority when they have work to do modernizing internal systems.

Health-care industry CIOs weren’t paying enough attention the last time Congress forced changes in their information systems by passing the Health Insurance Portability and Accountability Act. The headache of complying with the resulting security and privacy regulations hasn’t gone away. There’s still time, however, to weigh in on the Kennedy bill. The lawmaking process gets underway with a hearing before the Senate Committee on Health, Education, Labor and Pensions, which Kennedy chairs. At press time, the hearing was planned for sometime this month.

-Sarah Johnson

Update

FCC Opens Air for Wireless

The Federal Communications Commission voted 3-1 on Aug. 8 to free the broadcast spectrum for wireless applications by forcing TV makers to equip new sets with digital tuners by mid-2007. The FCC won’t turn over the spectrum until 85 percent of TVs purchased are digital (less than 1 percent are today).

With the ruling, that goal is more likely to be reached by the end of the decade. Wireless carriers that want to buy spectrum now win. TV manufacturers plan to sue, complaining the tuners will add $250 to the cost of a set (see Washington Watch, Aug. 15, 2002).

-Ben Worthen

Explainer: ICANN

The Internet Corporation for Assigned Names and Numbers (ICANN) is a private, nonprofit group set up by members of the Internet community in response to a 1998 U.S. Department of Commerce white paper that stated the need for an agency to handle global Net governance. ICANN has worked in cooperation with the Department of Commerce since November 1998, but its contract with Commerce ends this month.

ICANN manages the Internet’s domain name system?including creating new domain names?and allocates IP addresses. Its work is invisible to most end users. When a company registers a domain name, it deals with one of 156 registrars with which ICANN contracts.

The group is currently embroiled in a debate with Commerce and Netheads around the world over how much say it should have over technical policies for Internet privacy, security and ownership of Web addresses. ICANN wants more control; critics, including the Bush administration, say it should stick to managing bits and bytes.

If Commerce renews ICANN’s contract it will dictate the group’s agenda. No word on what happens if the department gives ICANN the boot, but rest assured, the Internet won’t go dark.

-S.J.