[Congressional Record Volume 153, Number 81 (Wednesday, May 16, 2007)]
[Senate]
[Pages S6194-S6195]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. STABENOW (for herself and Ms. Snowe):
  S. 1408. A bill improve quality in health care by providing 
incentives for adoption of modern information technology; to the 
Committee on Finance.
  Ms. STABENOW. Mr. President, the evidence showing the ability of 
health IT to reduce costs and improve quality of care is simply 
overwhelming.
  That is why Senator Olympia Snowe and I are reintroducing our Health-
Tech legislation to accelerate the adoption of health information 
technology.
  Businesses across the country are struggling to remain competitive in 
a global market with skyrocketing health care costs.
  The use of electronic medical records could save more than $80 
billion annually, reducing costs for businesses and taxpayers alike. We 
should be putting these systems in place immediately!
  And, despite the best doctors, nurses, hospitals, and other health 
care providers in the world, some patients just are not getting the 
care they need.
  Often times that is because our health care providers do not have the 
information they need about their patients, when they need it and where 
they need it.
  And, our health care system are not current1y set up to prevent 
errors; the most common medical errors include medication errors and 
the extra costs of treating drug-related injuries amount to at least 
$3.5 billion a year.
  As compelling as the cost savings is the promise health IT holds for 
improving the quality of our health care system.
  Getting health IT into the hands of our doctors, hospitals, nursing 
homes and community clinics will mean patients get the care they need, 
at the right time, and in the best setting.
  The value of health IT--saving lives and saving money--is well-known.
  So why is it not being used more widely?
  Health care providers are struggling to keep up with their daily 
needs; a major barrier to widespread use of IT is the initial 
investment cost.
  The costs of implementing health IT can be staggering.
  For example, the cost of an integrated electronic health record 
system for a three- to six-member physician practice is estimated to be 
$70,000-$100,000.
  And, the savings from using health IT go primarily to the patients, 
employers, and insurers, not the providers.
  If a patient needs one less x-ray because a hospital can pull up the 
x-ray performed by a radiologist in a different setting, that is one 
less co-payment for the patient, and one less bill to the patient's 
employer or insurer, or to the Medicare program.
  It only makes sense for the Federal Government to invest some seed 
money.
  Every day we delay providing Federal dollars, we delay getting health 
information technology systems in place, and businesses, taxpayers and 
patients pay in both dollars and lives.
  The bill that Senator Snowe and I are reintroducing today would 
address just that: It would put IT systems in the hands of providers by 
establishing a 5-year, $4 billion grant program for health care 
providers and by providing tax incentives and adjusting Medicare 
payments for providers who use these systems.
  The bill will be referred to the Finance Committee; Senator Snowe and 
I are both members of the committee and will work to include our 
legislation in any appropriate package the committee considers.
  We have made an important change to our bill this Congress.
  A patient's right to health information privacy is paramount, and is 
essential to the health care provider-patient relationship.
  Therefore we have added a requirement that health IT systems funded 
by our legislation ensure the privacy and security of personal medical 
information, and that patients be informed if there is a breach in the 
privacy of their medical record.
  We need to get this done. Widespread use of health information 
technology can revolutionize our health care system. Getting systems 
into the hands of providers is the first step.
  Our legislation has the support of many consumer, provider, labor and 
business groups including: AFL-CIO, Altarum, American Academy of 
Pediatrics, American College of Cardiology, American College of 
Emergency Physicians, American College of Physicians, American Health 
Care Association, American Heart Association, American Society of 
Health-System Pharmacists, Ascension Health, Automation Alley, 
BlueCross/BlueShield of Michigan, DaimlerChrysler, Detroit Medical 
Center, e-Health Initiative, Families USA, Federation of American 
Hospitals, Ford Motor Company, General Motors Corporation, Greenway 
Medical Technologies, Healthcare Information and Management Systems 
Society (HIMSS), HR Policy Association, IBM, Marquette General Health 
System, McLaren Health Care Corporation, Michigan Health and Hospital 
Association, Michigan State Medical Society, National Association of 
Children's Hospitals, National Association of Community Health Centers, 
National Business Coalition on Health, National Business Group on 
Health, National Partnership for Women and Families, National Rural 
Health Association, Oracle, Saint John Health, Saint Joseph Mercy 
Health System--Ann Arbor, Michigan; Saint Joseph Mercy Oakland--
Pontiac, Michigan; Saint Mary's Health Care--Grand Rapids, Michigan and 
Trinity Health.
  I urge my colleagues to support this legislation.
  Ms. SNOWE. President, today I join my colleague, Senator Stabenow of 
Michigan, in introducing the Health Information Technology Act of 2007, 
which will serve to improve the quality of health care through 
implementation of information technology, IT, in hospitals, health 
centers and physician practices throughout the country. Our legislation 
is necessary because as a nation we face two stark problems.
  The first of these is a serious patient-safety problem. Indeed if 
most Americans were told today that 98,000 lives were lost needlessly 
last year and a cure was available they would undoubtedly call for 
action. Yet the Institute of Medicine, IOM, has reported that medical 
errors inflict that toll every

[[Page S6195]]

year, and we have the technology at our disposal to dramatically reduce 
those deaths.
  The good news is that solutions exist. We have the technological 
ability to dramatically reduce medical errors and thus save lives. Many 
of us have heard about how drug interactions can be avoided by software 
systems which check a patient's prescriptions for hazards. Yet there 
are so many other applications which can improve health. For example, 
by reviewing and analyzing information, a health provider can help a 
patient better manage chronic diseases such as diabetes and heart 
disease, and avoid adverse outcomes.
  Our second major problem is the escalating cost of health care. Our 
health spending now comprises 16 percent of GNP, and the price of 
coverage has grown so high that the number of Americans without health 
insurance reached nearly 47 million last year. Those trends are 
threatening our economic competitiveness in the world and each 
American's health security as well. The answer is not to simply expand 
coverage, because on our current trajectory, escalating costs would 
simply erode our ability to provide care. It is clear that some 
fundamental changes must be made in health care.
  One of those changes must be the application of modern data 
technology to save lives and reduce costs. Indeed consider the savings 
when a physician can locate information efficiently. Tests do not have 
to be repeated and data is not delayed. In fact, a patient may obtain 
faster, higher quality care when, for example, multiple practitioners 
can review diagnostic test results right at their desktops. In an age 
where millions of Americans share family pictures over the internet in 
seconds, is it not long past time that a physician should be able to 
retrieve an x-ray just as easily?
  The President certainly recognizes the disparity in technology in 
health versus other parts of our economy. He has declared a goal for 
every American to have an electronic medical record within ten years. I 
concur, we need this and more. In fact, once that record is in place we 
can do so many things better. From preventing drug interactions, to 
managing chronic diseases, to simply helping providers operate more 
efficiently. Most of us have been told at one time or another, ``we're 
waiting to get the test results mailed,'' or ``we're still waiting for 
your chart.'' Health care is one of the last bastions of such 
inefficiency. Indeed it is often easier to track the service history on 
one's automobile than to see your own health history.
  The bad news is that the cost of new systems and a lack of standards 
have prevented us from reaping the benefits of new technologies. The 
President has made technology implementation a priority, and there is 
no doubt that a lack of standards has played a role in slowing IT 
adoption by many health care providers. One must know that a system 
purchased will be compatible with others, and that, no matter what may 
happen in the future to a vendor, the huge investment one makes in 
building an electronic medical records would not be lost. In other 
words, your system must be able to communicate with other systems, and 
your investment in building electronic medical records must be 
preserved. So when a patient moves, their electronic ``chart'' should 
be able to move right along with them, and their continuity of care 
shouldn't be interrupted.

  Yet standards alone aren't enough. Today many providers are 
struggling to make these investments, and for those which serve 
beneficiaries of Medicare, Medicaid and SCHIP, it can be exceedingly 
difficult. Our physicians, for example, have seen recent Medicare 
payment updates which have not even kept pace with inflation . . . and 
at the same time some expect that they will make a major investment in 
health IT.
  The failure of that logic is clear because we know where the benefits 
are realized. The benefits to patients are evident, in fewer delays, in 
better outcome, lives saved. Health IT reduces costs as well, but 
primarily to those who pay for services, not to providers. Indeed it 
has been estimated that 89 percent of cost savings accrue to those who 
pay for services. It should be obvious then that the Federal Government 
would invest in health IT to reduce its expenditures on Medicare, 
Medicaid and SCHIP.
  That is precisely what this legislation would do. Because as we look 
to the many studies and reports on health IT, one thing is clear. The 
annual cost savings actually exceeds the price of implementation. With 
that kind of return, it is indisputable that the Federal Government 
must employ health IT to see not only the savings in lives, but also 
better management of health care spending.
  This legislation does that by providing grants to spur adoption among 
physicians, hospitals, long term care facilities, and both federally 
qualified health centers and community mental health centers. These 
grants are targeted to help provide the health IT resources providers 
need to serve our Federal beneficiaries. In fact, the size of an 
allowable grant for each provider is keyed to the proportion of the 
patient care which they deliver to Federal beneficiaries. So we will 
help these providers deliver better care to those on Medicare, Medicaid 
and SCHIP . . . while working to see costs reduced in those programs. 
That is simple common sense.
  The legislation supports reasonable expenditures for a variety of 
expenses required to implement health care information technology. 
These include such components as computer hardware and software, plus 
installation and training costs. In addition, when installed we require 
that every system must meet the HHS Secretary's interoperability 
standards.
  Our new legislation even provides an alternative to those for-profit 
providers who do not wish to apply for a grant. Under this bill, such 
providers will be able to expense the cost of a qualified system.
  I again want to stress the first goal of this legislation: to help 
build a safer medical-delivery system. The great successes of our 
health care system are largely due to our highly committed and talented 
health care professionals. The problem we are addressing today is not 
theirs, but is an endemic weakness of the system they depend upon. 
However, to utilize the solution, the Federal Government must step 
forward and provide the leadership necessary to make system changes a 
reality.
  When the Medicare and Medicaid Programs began, we could only have 
dreamed about computerized clinical information systems. Now, today, we 
have this technology at our disposal, and I strongly believe that we 
cannot afford to delay implementation. In fact, as we face challenges 
in the financing of health entitlements, this is exactly the sort of 
initiative which will enable us to achieve the fundamental improvements 
to make these benefits more fiscally secure.
  I hope my colleagues will join us in support of this legislation so 
we may soon achieve the goals of improving patient safety and reducing 
our escalating health care costs.
                                 ______