The HR1 section on Health Information Technology is the third element of HR1 we have analyzed. There is a clear pattern.
I: Health Information Technology, SEC 3000 et al creates a $3 billion Government Czar and infrastructure to develop an Electronic Health Record as defined:
"(13) QUALIFIED ELECTRONIC HEALTH RECORD.—The term qualified electronic health record means an electronic record of health‐related information on an individual that— (A) includes patient demographic and clinical health information, such as medical history and problem lists; and (B) has the capacity— (i) to provide clinical decision support; (ii) to support physician order entry; (iii) to capture and query information relevant to health care quality; and (iv) to exchange electronic health information with, and integrate such information from other sources."
II: Broadband; SEC 201 Creates an NTIA Broadband Czar for $7 billion. It also mandates but does not fund 50 State plus territories Broadband Czars which will add to the real estate tax payers load.
III: Clinical Effectiveness SEC 802 creates a Clinical Effectiveness Czar and a massive organization. This is $700,000,000 for comparative clinical effectiveness research.
Each of these has a Czar, an organization, initial funding, and what appears to be a perpetual life. It is clear that HR1 is one of the greatest generators of Government bureaucracy ever known. Broadband is wasteful, clinical effectiveness is a natural part of the practice of medicine, as is evidence based medicine, and the medical record issue is best done in the private sector, as was the Internet with the IETF.
Now let us briefly look at the definition of the Electronic Health Record as in the Bill and as stated above. It is vague and it grossly fails to provide what we hare argued before is required. It must be patient focused, capable of handling complex multimedia elements, displayable and annotateable, and capable of be cross indexed and analyzable across and wide patient base and across a wide set of highly complex variables. If it has any use other than a data collection it must be able to be used for clinical trials. That should be a minimal benchmark.
The EHR section mandates "(iii) The utilization of a certified electronic health record for each person in the United States by 2014" Frankly is was easier to build an atomic bomb than to implement this nationally in five years. It is not the execution but defining what the answer is. The FAA has failed to upgrade the ATC systems for forty years and we all know what has to be done and there is a central point of control! How is this to be mandated from some Government Czar when the answer is unknown and the Government has an abysmal track record!
I would suspect that as one goes section by section through this massive bill that the theme of more, bigger, costly Government spending will be seen and that further the infrastructure built is both permanent and expansive. The shame is that no one was allowed to comment on these expenditures.
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