Why Newt Gingrich Believes National Health Records Are Coming Soon

One who believes that substantial IT investments are essential toward helping health-care providers reduce the number of errors and cost now inherent in the system is former House Speaker Newt Gingrich, who heads the Center for Health Transformation in Washington and last year authored the book Saving Lives and Saving Money (published by Alexis de Tocqueville Institution). Gingrich this week said the implementation of national electronic health records is not only inevitable but could be implemented by next January. He made his remarks in the keynote address at the annual Healthcare Information and Management Systems Society (HIMSS) conference this week in Orlando, Fla.

Perhaps Gingrich was preaching to the choir when addressing thousands of CIOs at the largest IT health-care conventions of the year, but he gave three reasons why he believes electronic health records are inevitable this year: first, the technology exists today. The recent passage of the Medicare bill means, among other things, everyone over age 65 is entitled to a comprehensive physical exam.

With that in mind, why not build a national Web-based system that requires physicians to enter the patient data,both administrative and clinical,into a repository that would be housed by Medicare? As a result, medical information can be readily accessed by the patient, pharmacist or any physician treating the patient down the road. Gingrich points out that this could happen as early this year because the Bush Administration is weighing an option whereby Medicare would pay for such a system.

"The records have to be interoperable and portable," Gingrich said. The reason he picked the benchmark of the physical exam for the patient at age 65 is the data can be entered by a doctor's office into a computer. "That single act will change the entire awareness by doctors of the inevitability of electronic heath records," Gingrich said.

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In an interview after his speech he expanded on his reasoning. "We're not trying to run the whole system the first day," he told VARBusiness. "All I want to do is a benchmark to get them to take on the physicals at 65 and then grow it out from there. That's a big enough bite. [But] it's a national bite." In other words, it builds enough ubiquity that physicians, if they want to get paid by Medicare, will use it. From there, it will grow organically, he reasons.

Why the need for a national electronic health record? That gets to Gingrich's second point. In a word, it's disaster preparedness. There exists the real threat of a biological attack. Even a biologically engineered flu could kill millions, he said. "I think it's very, very possible that at some point down the road, we will suddenly be faced with a problem that's going to require real-time data gathering and real-time information flow, and every week we go by without creating that system, we are running a risk for something that will be truly horrifying," he said.

The third reason centers around Gingrich's philosophy as a conservative. Implementing a national infrastructure of electronic health records could save patients, practitioners and insurers billions, if not trillions, of dollars in wasted costs. Not to forget saved lives. He says you have a 2,000 times greater chance of dying in a hospital due to a medical error than from a plane crash. Looking at it from that standpoint, "We certainly lose at least one shuttle a day between New York and Washington from medical errors," he says.

An electronic health record, if implemented properly, will create a more intelligent health system. It will empower patients to know more about their health, the costs and the track record of the doctors and hospitals that they are seeking treatment from. "As a result of that, we will save hundreds of billions of dollars and millions of lives," Gingrich said.

It all sounds compelling, but his time line may be somewhat bullish on the prognosis of success, most observers at HIMSS said. Gartner analyst Michael Davis points out that none of the issues Gingrich talked about are new but he certainly has the pull to raise the issue among lawmakers. "I think it's good to have someone of his level and visibility pushing the health-care agenda," Davis said. "The question is can we get the visibility finally in Washington to actually start the funding and the focus on national standards to drive cost reduction."

There are other barriers. While Gingrich insists interoperability is there, he's half right. An interoperability demonstration at HIMSS put on by the consortia Health Level Seven (HL7) and Integrating the Healthcare Enterprise (IHE) show impressive progress in linking patient-management systems to say, clinical applications. But by the group's own admission, there's still much work to be done before it's safe to say that full interoperability is there.

Also, Gingrich says if Medicare gets the green light to build the electronic health record, a systems integrator could have one ready to roll out by January 2005. Anything is possible. The way Gingrich sees it, do you really want to argue with a guy who has a strange name from Pennsylvania, who won a congressional seat in Georgia and went on to shift the balance of power in Congress?

We'll get a better sense of how things are looking if Medicare actually gets a green light to fund the effort. But no matter how this plays out, don't bet on the savings from such a system solving the federal deficit anytime soon.