[Congressional Record Volume 152, Number 125 (Friday, September 29, 2006)]
[Extensions of Remarks]
[Pages E1978-E1979]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




        INTRODUCTION OF THE PERSONALIZED HEALTH INFORMATION ACT

                                 ______
                                 

                        HON. PATRICK J. KENNEDY

                            of rhode island

                    in the house of representatives

                       Friday, September 29, 2006

  Mr. KENNEDY of Rhode Island. Mr. Speaker, I'm proud today to 
introduce the Personalized Health Information Act, which I hope will be 
a step in helping us redesign America's health care system.
  Our health care system today delivers some of the best care in the 
world, but can hardly be described as the best health care system. We 
spend more than 50% more on health care per capita than other 
industrialized nations, and yet our health outcomes are much worse. We 
all know the burden that health care costs are putting on America's 
families and businesses.
  Many of us have extolled the potential of information technology to 
begin transforming health care. I.T. can unlock data that is trapped in 
paper, catch human errors, help providers deliver the latest evidence-
based medicine, improve public health, reduce duplication and 
administrative costs, and provide new research capabilities. I.T. is by 
no means a silver bullet, but it is a tool that can be used to reorient 
health care, so that--finally--the system delivers the right care to 
the right people at the right time, as efficiently as possible.
  I've introduce other bills on this subject, and House and Senate 
negotiators are currently trying to work out a compromise health I.T. 
bill, but this bill today is a new approach. Those other bills, mine 
and others', have generally focused on the challenges of putting 
technology in providers' hands and building the related infrastructure. 
That goal is critical, and we pursue it vigorously. But it also is 
long-term.
  I believe that there are other, parallel steps we can take that can 
begin harnessing the power of technology to improve health outcomes and 
efficiency right now. And I think we can do so in a way that will begin 
changing the dynamics around health I.T. in a way that makes the 
longer-term goals more attainable.
  Web-based, consumer-controlled patient health records, PHRs, have 
been recognized by many to have great potential. After all, a PHR that 
contains a person's basic demographics, insurance information, and a 
current medications list would be extremely valuable, even if it 
contained nothing else. That PHR would mean every provider would have 
important basic information at the point of care. It would cut down on 
medication errors, and streamline administration.
  The problem is that while many organizations offer PHRs, few people 
actually use them. The Personalized Health Information Act is designed 
to jump-start the use of PHRs.
  This bill seeks to use the doctor-patient relationship to make the 
PHRs of value to the patients. Right now, most individuals see PHRs

[[Page E1979]]

as a lot of work with little benefit. If doctors begin using them with 
patients, however, the patients can get something out o them. So this 
bill will ask doctors to use PHRs to replace those dreaded clipboards 
when patients come to the office. If physicians do that, PHRs become 
more attractive. The patient can take ten minutes to put their 
information into a PHR, and use it with any doctor. If their doctors 
use them, the person will never have to fill out another clipboard 
again.

  Even better, the PHR can be a communications channel between doctor 
and patient. The physician, or other entities like the person's health 
plan or the Centers for Disease Control and Prevention or the American 
Heart Association, can send messages to the patient. For example, the 
patient can receive a reminder that she is due for a mammogram, or her 
prescription needs to be refilled. If physicians are willing, many PHRs 
can be used to allow e-consults and online scheduling as well.
  If we can bring a critical mass of consumers into PHRs, it could 
create a strong consumer demand for health I.T. that could dramatically 
accelerate adoption. And polls show that consumers do want the 
capabilities that PHRs provide. For example, a recent Wall Street 
Journal poll found that approximately three-quarters of respondents 
said in each case that they would like to be able to email their 
doctor, to schedule appointments online, to receive test results 
electronically, and to receive electronic reminders. Unfortunately, 
fewer than ten percent can do any of those things right now.
  Once physicians begin tapping into this pent-up demand by offering to 
use PHRs, I believe large numbers of patients will enroll. And 
conversely, as patients begin using PHRs, they will want their 
physicians to do so as well. Banks initially paid customers to use 
ATMs, but now they compete on how many ATMs they have and the 
functionality of their online banking offerings. Similarly, once health 
care consumers begin seeing the convenience and benefits of information 
technology, providers will want to be able to meet that demand. In this 
way, widespread use of PHRs could help give providers the incentive to 
make the investments in electronic medical records and other 
information technologies.
  PHRs carry the potential for significant health and efficiency gains 
by changing patient behavior. Research shows that when patients receive 
reminders and other messages, they better comply with prescriptions, 
preventive care, and other health care recommendations. When that 
happens, patient health improves, and it also brings financial benefits 
to health plans, purchasers, and pharmaceutical companies. Everyone 
wins.
  The Personalized Health Information Act would tap the value-added of 
PHRs by creating a public-private PHR Incentive Fund to pay physicians 
and other providers an incentive of at least $2 for every patient with 
whom they use a PHR. The doctor simply needs to use the PHR in lieu of 
the clipboard, ensure that the patient's medications list is updated 
after the appointment, and use the PHR for communicating with the 
patient in appropriate circumstances. These requirements would be 
carried out by office staff and put minimal burden on doctors. Medicare 
would contribute $2 to the Fund for each beneficiar enrolled, and 
private plans, drug and device manufacturers, and other private parties 
could do the same.

  To qualify physicians for the payment, PHRs will need to meet certain 
minimum standards. They need to be entirely in the control of the 
individual, and will have to guarantee the portability of the data, so 
that the individual can take the information at any time. They'll have 
to meet interoperability standards and privacy and security standards. 
The PHR will also need to be able to send patient-specific messages in 
appropriate situations. Partners in the Fund would be able to have 
messages sent to patients with whom they have relationships via the 
PHRs, with strong safeguards to ensure that the messages are 
independently verified to be objective, accurate, and relevant to the 
patient. Absolutely no marketing or solicitations would be permitted. 
The individual must have the right to opt out of these messages, either 
entirely or from particular sources, at any time. In addition, the bill 
creates a Consumer Protection Board to ensure that these standards are 
met.
  By paying incentives to physicians from a public-private fund, the 
Personalized Health Information Act captures the value that PHRs can 
create while tapping the strongest force in health care: the doctor-
patient relationship.
  This bill is not a silver bullet, Mr. Speaker, and will not solve all 
of the challenges inherent in moving from a 20th century pen-and-paper 
system to a digital system for the 21st century. But it can 
inexpensively and quickly give millions of consumers and physicians a 
stake in that transition.
  Before I close, I want to acknowledge the efforts of Dr. Edward 
Fotsch, who has done much to develop the ideas underlying this bill and 
has helped pull together feedback and input from physicians, consumer 
groups, payers, pharmaceutical companies, and others. I also need to 
express a debt of gratitude--again--to former Speaker Newt Gingrich and 
David Merritt at the Center for Health Transformation, who have been 
unlikely but terrific allies in the quest for, as Speaker Gingrich 
would say, a 21st century intelligent health system.
  There are too many Americans who are being let down by a health care 
system that is unable to consistently and efficiently deliver the 
world-class care that it is capable of. I hope that this legislation 
will bring us one step closer to the health care system we need and 
deserve.

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