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REMARKS BY:
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TOMMY G. THOMPSON, SECRETARY OF HEALTH AND HUMAN SERVICES
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PLACE:
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The Willard Hotel, Washington, D.C.
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DATE:
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May 6, 2004
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Health Information Technology Summit
Good afternoon. I'd like to welcome the brightest minds in the fields of health care and IT as well as reporters who cover business, health care, privacy, and other topics. I'd also like to thank Anthony Principi, Nancy Johnson, Newt Gingrich, Carolyn Clancy, and Bill Winkenwerder for helping me with today's event.
My friends, we have entered an exciting new era in American medicine. From cholesterol drugs to knee replacements, from PET scans to the Gamma Knife, our medical industry in recent years has brought an amazing number of new treatments to patients and improved their quality of life.
But the most remarkable feature of this twenty-first century medicine is that we hold it together with nineteenth-century paperwork. This is just inexcusable. And it has to change. I am not a patient man. And I'm here today to draw a line in the sand. It's time to make big, radical changes and transform our health care system. For health care IT, the twenty-first century starts today.
Americans spend more resources on health care than people in any other industrialized nation. But we get the right treatment less than 50 percent of the time. Many of you saw the RAND study this week on this topic. The study said that failure to integrate electronic health records was a major part of the problem.
Our current system of manila folders and loose slips of paper has got to go. We license new doctors who have vast knowledge, deep compassion-and illegible handwriting, and they scribble prescriptions that nurses and pharmacists misread or mis-transcribe. A nurse who reads a script "myoo-jee" as an "MG," could administer too much of a drug-milligrams instead of micrograms. Some unrelated drugs have similar names. For example, when a drug called Losec was introduced, confusion with Lasix led to patient deaths. Writing or reading a decimal point in the wrong place also causes far too many medical errors.
The Institute of Medicine estimates that medical errors kill 45,000 to 98,000 Americans each year in hospitals. Even more Americans are disabled. Another kind of medical error is less serious to health but is still a burden to patients: unnecessary tests, unnecessary x-rays, unnecessary doctor visits, and unnecessary hospitalizations. All of these events happen routinely because providers lack complete patient data.
My friends, this is unacceptable. Americans deserve better. And Americans are going to demand better. I am not a patient man, so I want to change this fast.
Patients deserve advice and care from providers who are fully informed about their medical history, including past injuries, tests, diagnoses, and treatments, as well as whatever research results and public health notifications might be relevant. They shouldn't have to wait for redundant tests or calls to their previous doctors.
Doctors deserve to focus on the quality of their care, not the quantity of their paperwork. And both patients and doctors deserve systems that will prevent medical errors before they become medical and legal problems.
To achieve these goals, Americans deserve a seamless and secure national health information infrastructure. This system must provide accurate, complete patient data to providers wherever they are, in time to be useful-even in an emergency. It must allow doctors to prescribe medications electronically, so the medications can be checked for safety before they are administered. And it must do all this without revealing personally identifiable information without the patient's consent.
A good health information system could save our economy $140 billion a year. That's about ten percent of our total health care spending, and that's a conservative estimate. Later, I'll ask Blackford Middleton to discuss two segments of that total.
We all know that this system-a system that's safer, faster, and more efficient, is inevitable. It is inevitable because sooner or later patients will demand it when choosing doctors, hospitals, and pharmacies.
Consumers are asking for and getting more control over their families' health care. And informed consumers will choose doctors and hospitals that offer the convenience, quality, safety, and cost-effectiveness of electronic records and e-prescribing. When more people are making more of their own decisions and paying for health care more directly, they will demand better service.
Just last, week, President Bush laid out a goal: within ten years, most Americans should have electronic health records. I think we can do it even faster.
And I want to challenge everyone in this room with this question: What will you do to bring these essential, inevitable advances to patients sooner?
Government can help, and we already are. My Department has led the government-wide effort in endorsing health information technology standards for government use - and we hope this will stimulate the industry to adopt it. The new Medicare law requires HHS to adopt e-prescribing standards by September of 2005, test them in 2006 with the new Medicare drug benefit, and promulgate them in 2008. I think that timetable is far too slow. So I will insist that we develop and implement these standards much faster.
And with HHS support, the voluntary international health standards-setting organization known as HL7 today announced a favorable vote on a functional model of an electronic health record. The model is a critical step toward establishing common functions for these records. Now we are asking HL7 to take the next step by defining a standard for exchanging complete electronic health records.
We have licensed a standard medical terminology SNOMED, and made it available without charge to everyone in America. Today I am delighted to announce that SNOMED is available on the Library of Medicine web site.
I am happy to announce that today the Consolidated Health Informatics initiative has endorsed 15 messaging and formatting standards. This is on top of the 5 CHI standards I announced last March. This completes the initial phase of their work.
And, if Congress approves the President's budget, we will spend $50 million next year in grants for NHII.
We are excited to coordinate all of these activities under the new National Health Information Technology Coordinator at HHS. And today I am delighted to announce the appointment of the very first national coordinator, David J. Brailer. Dr. Brailer is currently a senior fellow at the Health Technology Center in San Francisco. Please stand up, David. David will report directly to me. So you can hold me responsible for real results, in the government and in the health care industry. But I'm going to hold you responsible.
There are three fundamental tasks we need to get done. First, we need to adopt standards. We've taken some basic steps: SNOMED, and our Consolidated Health Initiative for federal agencies. What can we do to adopt better standards faster?
Second, we need to promote widespread adoption of e-prescribing and electronic health records. The agreement that's being announced today by HL7 is a key first step. And we plan new finance initiatives that will be restricted to products that meet minimal standards. How can we do this quickly? How can we better align incentives?
Third, we need to encourage the development of local health information exchanges. We're providing some funding this year through Carolyn Clancy's agency. And the President has proposed new seed money to get things started in multiple communities. But what else could we be doing, or doing differently, to move even faster?
These are our questions today. And I warn you, ladies and gentlemen, I am an impatient man. I want more movement while I'm Secretary. And when I need medical care in the future, I want my doctor and hospital to have access to a wonderful new electronic system. Well, let me amend that - I want the system to be in place a long time BEFORE I need it, because I'm not planning to need it anytime soon.
But millions of others need it. They need it now. The health professions need it. Our hospitals need it. Our doctors have worked in the dark long enough. Working together, we can turn on the light.
So how close to "NOW" can we get, and do the best job possible?
Last Revised: May 6, 2004
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