Academy Criticizes Health IT Legislation as Weighted Toward Large Entities

The AAFP has objected to key provisions of a health information technology, or HIT, bill because of the legislation's emphasis on federal support for large entities and hospitals instead of small and medium-sized practices where most health care interactions occur.

The Wired for Health Care Quality Act, S.B. 1693 (at the Library of Congress' THOMAS Web site, type "S 1693" in the search bar after selecting "Bill Number"), would award grants to help health care providers purchase HIT systems that would link to local or regional health information plans. Introduced June 26 by Sen. Edward Kennedy, D-Mass., the bill recently passed the Senate Health, Education, Labor and Pensions Committee.

The AAFP has sent a letter to the 10 Senate sponsors of the bill, saying, "We will not improve health care in America if federal dollars only empower large enterprises -- at great cost and complexity -- to communicate with other big institutions, while doctors and patients in tens of thousands of local community practices and clinics cannot access and share necessary information. It is time to recognize that over 80 percent of health care is delivered in doctors' offices and to apply modern HIT in those settings."

Although the Academy supports competitive grants to ensure HIT is widely adopted, the letter adds, as the bill currently stands, it is "far too burdensome and unrealistic for small and medium-sized practices." The letter points out that the bill, if adopted, would require practices to

The Academy's letter notes that, "Connected medical homes, defined as practices that provide comprehensive primary care, are more likely than other practices to be able to automate the patient care processes necessary for quality improvement and accountability, as well as for public health and bioterrorism protection.

"To ensure a return on investment, data collection should be the by-product of the use of electronic medical records (EMRs) in connected medical homes and not the reason they are purchased in the first place. Physicians should purchase HIT systems for quality improvement that is based on this data collection."

The proposed legislation also would provide the public with reports on national, regional and provider-specific performance. But there are no provisions in the bill requiring the involvement of physician organizations in generating those reports, "although information released to the public would be provider-specific," says the AAFP.