Meeting the Need for Interoperability and Information Security in Health IT

Opening Statement By Chairman Bart Gordon

I want to welcome everyone to today’s hearing on Meeting the Need for Interoperability and Information Security in Healthcare IT. Over the past 20 years, we have experienced a dramatic change in the way we share information because of the rapid emergence of information technology. Nearly every industry across our economy, from financial services to media to retail, has embraced information technology and integrated it seamlessly into daily operations. Yet, the healthcare industry has lagged far behind.

The broad use of IT in the healthcare sector could have far reaching benefits, including cost savings in the billions, improved quality of care, and fewer dangerous medical errors. Though there are a number of factors that have contributed to slow adoption of health IT, I believe one of the most significant is the lack of technical standards for interoperability and the protection of patient privacy.

Interoperable communications for the exchange of information are a requirement for conducting business across the country and around the globe. Unfortunately, the healthcare industry has not yet adopted common standards to allow for the broad management and transmission of health related information.

According to most estimates, a fully interoperable healthcare IT system could save U.S. healthcare tens of billions of dollars a year, and help prevent some of the mistakes that lead to the deaths of over 98,000 patients annually.

But meeting the challenge of developing and maintaining such a system is not simple. Most Americans get their primary healthcare at offices with five or fewer doctors. These small offices cannot easily afford the initial investment in health IT equipment and software, or the time for training on complicated systems. Doctors and health IT systems developers also face medical privacy laws that vary state by state, some of which do not support the digital exchange of patient information . Much more work needs to be done to update laws and regulations in order to encourage the adoption of this important technology.

But the biggest barrier to the broad implementation of health IT systems is the lack of technical standards to support interoperability while protecting data security.

It is wasteful to start investing in technology until we know it is interoperable, as the cost to upgrade to new systems would eat up any immediate cost savings.

To achieve interoperability, we need simple technical standards for data formats, data exchange protocols, and other system communication needs. These will enable different manufacturers and vendors to build and sell medical software and hardware devices that are based on the same underlying communication techniques. Doctors and hospitals are reluctant to invest in health IT systems that are not interoperable with other such systems owned by other healthcare providers.

The National Institute of Standards and Technology (NIST) is uniquely positioned to meet this challenge.

NIST was instrumental in guiding the creation of standards for the financial services industry and others as they transitioned to an IT-based business model. NIST also sets and maintains the technical standards for IT security across the federal government to protect against data theft and unauthorized access. That expertise is essential for helping to create interoperability standards for health IT.

In addition to discussing the challenges of implementing a health IT system in the U.S., our witnesses today will be addressing HR 2406, which authorizes NIST to increase its efforts to support the integration of the healthcare information enterprise in the United States. This bill is not a complete solution to the problem we are discussing today.

But it is my hope that it is a starting point for the broad efforts needed on the part of the Federal government, state governments, and the healthcare and IT industries to move towards a fully interoperable national health IT system.

The bill is based on the recommendations of a report by the President's Information Technology Advisory Committee (PITAC) in 2004 and a study by the National Academies in 2005. It instructs NIST to advance health IT integration while working with healthcare representatives and federal agencies to develop technical roadmaps for health IT standards. The bill also requires NIST to create or adopt existing technology-neutral guidelines and standards for federal agencies. It directs the Department of Commerce to establish a Senior Interagency Council on Federal Health IT Infrastructure to coordinate the development and deployment of federal HIT systems. And finally, it mandates a university grant program at NIST for multidisciplinary research in health IT-related fields.

Secure, interoperable health IT systems are crucial for saving time and money. But we cannot lose focus on the ultimate goal of all health policy: protecting patients’ health and saving lives. I typically do not tell personal stories during hearings, but if the Committee will indulge me, I want to share a story that drives home the purpose of this legislation. The Committee staffer who has been handling health IT issues for me is a gentleman named Mike Quear.

Last year, Mike had open heart surgery and was diagnosed with diabetes. He was concerned what would happen if he ever needed emergency care, so he started keeping a record of every condition that he had, every specialist he visited, and every medication he was prescribed on a small card in his wallet. That card was the only comprehensive record of care that Mike had available to him.

This past August, Mike had a stroke and was taken to the hospital, where emergency room doctors were immediately able to evaluate his preexisting conditions, contact Mike’s team of specialists and provide him with the best care because they had that card. Thankfully, he’s now recovering at home. If those records hadn’t been available, who knows what might have happened.

I would venture to guess that not many people in this room, or in this country, take the time to record their medical history on a wallet card. Nor should we need to. Technology in this country is far enough advanced that we should be able to expect doctors to access our complete medical records in any emergency situation.

I’m eager to hear our witnesses’ thoughts and recommendations on how to most effectively promote the broad implementation of health information technology systems in the near future to save money, save time, and save lives.

Witnesses

Panel

2 - Ms. Noel Williams
Senior Vice President and Chief Information Officer Hospital Corporation of America Hospital Corporation of America
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3 - Ms. Linda Kloss
Chief Executive Officer American Information Health Management Association American Information Health Management Association
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5 - Mr. Mike Raymer
Vice President and General Manager Product Strategy and New Business Initiatives General Electric Healthcare Integrated IT Solutions Product Strategy and New Bu
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1 - Dr. David Silverstone
Clinical Professor of Ophthalmology and Visual Sciences Yale School of Medicine Yale School of Medicine
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4 - Mr. Justin T. Barnes
Vice President of Marketing and Government Affairs Greenway Medical Technologies Greenway Medical Technologies
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