AAFP Shapes Federal Legislation on Information Technology

The AAFP has played a major role in strengthening key provisions of a health information and technology bill that would use financial incentives to create qualifying personal health records, or QPHRs, for Medicare patients and their physicians.

Rep. Patrick Kennedy, D-R.I., introduced the legislation last year. That bill did not pass out of committee, and Kennedy re-introduced the bill on March 7. The new bill, which is co-sponsored by Reps. Dave Reichert, R-Wash., and Adam Smith, D-Wash., contains enhanced financial incentives and patient protection provisions based on input from the Academy.

"We received a great deal of input from the AAFP folks about how this bill could better meet the needs of family physicians and their patients," said Michael Zamore, Kennedy's policy adviser.

The legislation, known as the Personalized Health Information Act, H.R. 1368, (at the THOMAS Web site, type "HR 1368" in the search box after selecting "Bill Number") has been referred to both the House Energy and Commerce Committee and the House Ways and Means Committee. It focuses heavily on the patient/physician relationship, particularly on giving patients access to and control of their health data while furnishing physicians with a more accurate minimum data set of information.

The legislation also is incentive-based. For example, it establishes a program to make financial incentives available for the creation of QPHRs, and includes a provision to set up a personal health record incentive fund to pay physicians a minimum of $3 annually for each patient who uses a QPHR, an increase of $1 from last year's legislation. Kennedy's staff increased the minimum payment at the behest of the Academy.

"Initially they were going to pay $2; now it is $3, and that is still most likely not enough," said David C. Kibbe, M.D., senior advisor to the AAFP's Center for Health Information Technology, who worked closely with Kennedy's staff on the legislation. "However, there is a provision that would allow private sector parties to contribute to the incentive fund so the (reimbursement) could go significantly above $3."

The Academy also helped convince Kennedy's staff to include language in the bill that would expand on provisions contained in the Health Insurance Portability and Accountability Act of 1996, or HIPAA, as a way of enhancing patient protections, Kibbe said. Namely, any QHPR service provider would be considered a covered entity under HIPAA regulations safeguarding patients' privacy rights.

Finally, the AAFP had a profound impact on shaping the bill's data liquidity requirements. Based on input from the Academy, Kennedy's staff included a provision in the bill that would make patient health information available to patients in a standards-based electronic format, but only if the data already are stored in an electronic format.

Kennedy did not introduce the bill as comprehensive legislation, which would have made it unlikely the bill would pass the House on its own. Instead, the legislation will become part of a larger IT bill that will be addressed by the House later this year.

"In terms of moving the ball politically, I think the Academy was very successful," said Kibbe.

Zamore agreed, saying that Kennedy is "grateful for the opportunity to work with the Academy and applauds its leadership."

He added, "From my boss's perspective, the Academy is at the forefront of embracing IT in terms of improving patient care."