[Congressional Record Volume 150, Number 125 (Wednesday, October 6, 2004)]
[Senate]
[Pages S10581-S10582]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DODD (for himself and Mr. Kennedy):
  S. 2907. A bill to amend the Public Health Service Act to improve the 
quality and efficiency of health care delivery through improvements in 
health care information technology, and for other purposes; to the 
Committee on Health, Education, Labor, and Pensions.
  Mr. DODD. Mr. President, today I am pleased to announce the 
introduction of the Information Technology for Health Care Quality Act. 
Let me thank Senator Kennedy for joining me in introducing this bill. 
By encouraging health care providers to invest in information 
technology (IT), this legislation has the potential to bring 
skyrocketing health care costs under control and improve the overall 
quality of care in our nation.
  We are facing a health care crisis in our country. The Census Bureau 
recently released a report showing that 45 million Americans were 
without health insurance in 2003--an increase of 1.4 million over 2002. 
In many respects, we have the greatest health system in the world, but 
far too many Americans are unable to take advantage of this system.
  The number of uninsured continues to rise because the cost of health 
care continues to soar. Year after year, health care costs increase by 
double-digit percentages. The cost of employer-sponsored coverage 
increased by 11 percent this year, after a 14 percent increase in 2003. 
Employers are dropping health care coverage because they can no longer 
afford to foot the bill.
  One of the ways to provide health care coverage to every American is 
to reign in health care costs. And expanding the use of IT in health 
care is the best tool we have to control costs. Studies have shown that 
as much as one-third of health care spending is for redundant or 
inappropriate care. Estimates suggest that up to 14 percent of 
laboratory tests and 11 percent of medication usage are unnecessary. 
Finally, and perhaps most disturbingly,

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we know that it takes, on average, 17 years for evidence to be 
incorporated into clinical practice. Along these same lines, a recent 
study showed that patients receive the best evidence-based treatment 
only about half the time.
  Significant cost-savings will undoubtedly be realized simply by 
moving away from a paper-based system, where patient charts and test 
results are easily lost or misplaced, to an electronic system where 
data is easily stored, transferred from location to location, and 
retrieved at any time. With health IT, physicians will have their 
patients' medical information, at their fingertips. A physician will no 
longer have to take another set of X-Rays because the first set was 
misplaced, or order a test that the patient had six months ago in 
another hospital because she is unaware that the test ever took place. 
The potential for cost-savings from simply eliminating redundancies and 
unnecessary tests, and reducing administrative and transaction costs, 
is substantial.
  Of course, when we consider the improved quality of care and patient 
safety that will result from wider adoption of health IT, the impact on 
cost is even greater. For example, IT can provide decision support to 
ensure that physicians are aware of the most up-to-date, evidence-
based best practices regarding a specific disease or condition, which 
will reduce expensive hospitalizations. Given all of these benefits, 
estimates suggest that Electronic Health Records (EHRs) alone could 
save more than $100 billion each year. The full benefits of IT could be 
multiple hundreds of billions annually. Such a significant reduction in 
health care costs would allow us to provide coverage to millions of 
uninsured Americans.

  The benefits of IT go beyond economics. I am sure that all of my 
colleagues are familiar with the Institute of Medicine (IOM) estimate 
that up to 98,000 Americans die each year as a result of medical 
errors. A RAND Corporation study from last year showed that, on 
average, patients receive the recommended care for certain widespread 
chronic conditions only half of the time. That is an astonishing 
figure. To put it in a slightly different way, for many of the health 
conditions with which physicians should be most familiar, half of all 
patients are essentially being treated incorrectly.
  Most experts in the field of patient safety and health care quality, 
including the IOM, agree that improving IT is one of the crucial steps 
towards safer and better health care. By providing physicians with 
access to patients' complete medical history, as well as electronic 
cues to help them make the correct treatment decisions, IT has the 
potential to significantly impact the care that Americans receive. It 
is impossible to put a value on the potential savings in human lives 
that would undoubtedly result from a nationwide investment in health 
care information technology.
  It might seem counterintuitive that we can realize tremendous cost 
savings while, at the same time improving care for patients. But in 
fact, improving patient care is essential to reducing costs. IT is the 
key to unlocking the door--it has the potential to lead to improvements 
in care and efficiency that will save patients' lives, reduce costs, 
and reduce the number of uninsured.
  Unfortunately, despite the impact that IT can have on cost, 
efficiency, patient safety, and health care quality, most health care 
providers have not yet begun to invest in new technologies. The use of 
IT in most hospitals and doctors' offices lags far behind almost every 
other sphere of society. The vast majority of written work, such as 
patient charts and prescriptions, is still done using pen and paper. 
This leads to mistakes, higher costs, reduced quality of care, and in 
the most tragic cases, death.
  There is no question in my mind that the Federal government has a 
significant role to play in expanding investment in health IT. The 
legislation that I am introducing today defines that role. First, this 
bill would establish Federal leadership in defining a National Health 
Information Infrastructure (NHII) and adopting health IT standards. 
While I am pleased that the administration has already appointed a 
National Coordinator for Health Information Technology, I believe that 
the authority given to the Coordinator and the resources at his 
disposal are not equal to the enormity of his task. That is why my 
legislation creates an office in the White House, the Office of Health 
Information Technology, to oversee all of the Federal 
Government's activities in the area of health IT, and to create and 
implement a national strategy to expand the adoption of IT in health 
care.

  This office would also be responsible for leading a collaborative 
effort between the public and private sectors to develop technical 
standards for health IT. These standards will ensure that health care 
information can be shared between providers, so that a family moving 
from Connecticut to California will not have to leave their medical 
history behind. At the same time, this bill would ensure that the 
adopted standards protect the privacy of patient records. While the 
creation of portable electronic health records is an important goal, 
privacy and confidentiality must not be sacrificed.
  This legislation would also provide financial assistance to 
individual health care providers to stimulate investment in IT, and to 
communities to help them set up interoperable IT infrastructures at the 
local level, often referred to as Local Health Information 
Infrastructures--LHIIs. IT requires a huge capital investment. Many 
providers, especially small doctors offices, and safety-net and rural 
hospitals and health centers, simply cannot afford to make the type of 
investment that is needed.
  Finally, this legislation would provide for the development of a 
standard set of health care quality measures. The creation of these 
measures is critical to better understanding how our health care system 
is performing, and where we need to focus our efforts to improve the 
quality of care. IT has the potential to drastically improve our 
ability to capture these quality measures. All recipients of Federal 
funding under this bill would be required to regularly report on these 
measures, as well as the impact that IT is having on health care 
quality, efficiency, and cost savings.
  The establishment of standard quality measures is also the first step 
in moving our nation towards a system where payment for health care is 
more appropriately aligned--a system in which health care providers are 
paid not simply for the volume of patients that they treat, but for the 
quality of care that they deliver. To this end, my legislation would 
require the Secretary of Health and Human Services to report to 
Congress on possible changes to Federal reimbursement and payment 
structures that would encourage the adoption of IT to improve health 
care quality and patient safety.
  It is time for our country to make a concerted effort to bring the 
health care sector into the 21st century. We must invest in health IT 
systems, and we must begin to do so immediately. The number of 
uninsured, the skyrocketing cost of care, and the number of medical 
errors should all serve as a wake-up call. We have a tool at our 
disposal to address all of these problems, and there is no more time to 
waste. I urge my colleagues to support this legislation.
                                 ______