President Barack Obama signed the American Recovery and Reinvestment Act into law today. Fifty-nine billion dollars will flow into healthcare, partly to fund the development of national electronic medical records. But there are other healthcare reforms, too, and each may be met with controversy. Surprising to some, there may be some packaging angles!
Some citizens are concerned about the privacy of electronic medical records. Just who will be reading them, and just exactly what will they be doing with them? I read these fears and more as I searched for the ARRA on-line and happened upon some Internet conspiracy chat.
Another ARRA clause (taken from the House draft dated January 15) that concerns some is the development of “comparative effectiveness of healthcare treatments.” Money may now be available to “encourage the development and use of clinical registries, clinical data networks, and other forms of electronic health data that can be used to generate or obtain outcomes data.” Some bloggers fear that critically ill or elderly patients will be denied treatment because the data may reveal that treatment won’t matter, so why waste money on it?
Others bristle at the funding of prevention and wellness. The House version of the act included $545,000,000 for chronic disease, health promotion, and genomics programs;” $50,000,000 for injury prevention and control; and $500,000,000 for evidence-based clinical and community-based prevention and wellness strategies . . . will shall include evidence-based interventions in obesity, diabetes, heart disease, cancer, tobacco, cessation and smoking prevention, and oral health. . . .” (I am waiting for the signed-act link to verify that these all were included, but it was crashing today . . .) Some fear that Big Brother may soon dictate how you live and what you consume, or else be denied healthcare.
I cannot calm these fears, because we all have our own fears about government gone wrong. But if you think back to your own healthcare experiences, you may find that at some point, somewhere, you may have wished for the results of these measures.
For instance, I will share one from my family. Just yesterday a relative in pain from a neck injury went to fill a prescription at our local chain drug store. Covered under a PPO, my relative was shocked to hear that her insurance plan dictated “step therapy,” which according to medicinenet.com is “the practice of beginning drug therapy for a medical condition with the most cost-effective and safest drug therapy and progressing to other more costly or risky therapy, only if necessary.” Some may say that already sounds a little like socialized medicine.
After getting over her shock, my relative said, OK, fill the prescription with the covered drug. Trouble was, the doctor had to approve the prescription change but was no longer reachable, given the holiday, so she couldn’t even get one of the prescriptions filled.
I wondered why the doctor wouldn’t have foreseen this and instead chosen a widely covered drug. And then I realized–without connectivity, the continuity of healthcare breaks down. An electronic system could have enabled the doctor to identify a covered drug and to communicate the prescription to a stocked pharmacy, without delay or error.
I am sure that my relative’s experience in the pharmacy is not unique–I have stood and overheard pharmacists tell patients that “I couldn’t get a hold of your doctor today, and we faxed twice . . . .” You may have even gone through this yourselves.
Will Obama’s rewiring of the healthcare system remedy this ill? Not sure. The act discusses electronic records, but some argue that e-prescribing is part of e-health, as is automatic product identification. There seems to be a lot of systems to bring online, and a lot of assurances that the collected data will be used to promote healthcare, not deny it.
Connectivity is needed, and at some point, you will need to plug into the system, too, with automatic product identification.