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Health Information and Management Systems Society Annual Conference

February 23, 2011
Orlando, Florida

Remarks as prepared for delivery

Good morning. Thank you for that kind introduction. It’s great to be here with you today.

I want to begin by thanking all of you for the work you’re doing to improve health care for Americans. From the engineers who are designing the health information technologies of the future, to the health professionals who are employing them in hospitals, doctor’s offices, nurse’s stations, and health centers across the country, the energy, creativity, and commitment to improving health in this room are a very positive sign for the future of health care in America.

I also want to congratulate HIMSS on your 50th anniversary. For many organizations, that’s an entire lifetime. But when it comes to health IT, I think you’ll agree that we’re just getting started.

Over the last few decades, we’ve seen information technology transform industry after industry. We’ve watched 24-hour ATMs replace bankers’ hours and credit cards revolutionize retail. We’ve seen on-line shopping surge, social networking become a way of life, and in many cases, forgotten how we ever lived or worked without our smart phones.

For Americans, these transformations have brought huge benefits – better service, more convenience, and lower costs. For our economy, these transformations have meant countless new jobs. The top five internet companies today are all American. Over the last ten years, their workforces have grown nearly 600 percent.

Today, we are poised for a similar revolution in health care. When President Obama came into office, only two in ten doctors and one in ten hospitals used even a basic electronic health record system. But in the last two years, the share of primary care providers using a basic electronic health record has gone from under 20 percent to nearly 30 percent.

And when doctors and hospitals were recently asked whether they planned to apply for new incentive payments that will require them to be meaningful users of electronic health records by 2015, more than four out of five hospitals and more than two out of five office-based physicians said yes.

If those numbers hold, this would be the fastest growth in health information technology that we’ve ever seen in this country – or in any other. And it’s been made possible because industry, the health care community, and government all worked together.

It’s taken innovators like the ones in this room who are developing better products that are more powerful and easier to use.

It’s taken health care providers who are showing how this technology can be used to improve care, cut paperwork, lower costs, and track outcomes.

It’s taken states and communities across the country that are making it easier for providers to share health information electronically, with full protections on privacy, in order to deliver better care for their patients.

And it took a historic piece of legislation passed by Congress and signed by President Obama two years ago last week.

In the last twenty-four months, the HITECH Act has taken a battering ram to many of the obstacles that were preventing health information technology from spreading.

Whether it’s creating 62 health IT Regional Extension Centers to help small practices and critical access hospitals to set up their health IT systems, or investing in health information exchange, or supporting Beacon communities that can be models for the rest of the country – the HITECH Act has made it easier than ever to start using an electronic health record.

And by providing bonus payments for hospitals and eligible providers that adopt electronic health records and use them to improve patient care, the Act has made it more affordable than ever too.

Over the last two years, we’ve created unprecedented momentum behind health information technology. And I know that some of you may be wondering how that momentum will be affected by last fall’s election. I think you can answer that question by looking at a list of who has spoken here at HIMSS in the past.

Senator John Thune, former Speaker Newt Gingrich, and former President George W. Bush are all Republicans. Majority leader Nancy Pelosi, Senator Tom Udall, and Secretary of State Hilary Clinton are all Democrats. They don’t have much in common. But they’ve all come here to talk about why electronic health records are critical to our country’s future.

So while there are disagreements in Congress on health issues, health IT is one area where both parties stand together. And today, I can tell you that this Administration stands with them from President Obama on down.

  1. Health IT and economic growth

We believe in health information technology because it’s an investment in a stronger economy. As the President has said, to win the future, America must out-innovate the world in the 21st century just as we did in the 20th century.

America has always been a country of trailblazers, and today, health IT is one of our most promising new frontiers. To see its huge job-creating potential, just look at the 231 companies that have had a health IT product certified. Of these companies, nearly two thirds have fewer than 50 employees. Any one of them might be the next Google or Microsoft.

Earlier this morning I got to have breakfast with the CEOs of about 15 of these companies. And the work they’re doing is incredibly exciting. Every day, they’re finding new ways to make doctors and nurses better at what they do and give patients more control over their health.

Now, there’s no doubt we’re in a tough budget environment. That’s why President Obama has proposed a budget that will reduce the deficit by $400 billion over the next decade, bringing domestic spending down to the lowest share of our economy since the 1950s. But as important as it is to make cuts where we can, it’s equally important to keep the investments that will keep our economy growing.

Just as businesses don’t zero out their R&D budgets when the earnings fall and families don’t raid their college savings accounts at the first sign of an economic slump, we can’t afford to throw away the investments that will secure our future. That’s why, even as our 2012 budget makes significant cuts, it also calls for an increase of over 25 percent in the budget of the Office of the National Coordinator for Health Information Technology.

But our commitment to health IT is about more than creating the jobs of the future. It’s also about improving America’s health.

America has the best doctors and nurses in the world. Our hospitals offer the most advanced treatments. We devote more resources to health than any country by far. Yet because of breakdowns in our delivery system, Americans continue to live sicker and die younger than many of our peers around the world.

Part of the problem is that when Americans walk into a hospital or doctor’s office, we often fail to get the right care. Each year, nearly two million Americans develop a health care-associated infection – not an infection you bring to the hospital, but one you get once you’re already there. At the same time, 30 percent of our health care spending – early $700 billion a year – goes to pay for services that may not improve people’s health.

The health law President Obama signed last March, the Affordable Care Act, starts to address these problems. For example, it contains a series of reforms that change the way we pay for care to reward quality, not quantity. And it supports new models like medical homes in which health care providers can work together to help patients manage their chronic conditions.

Electronic health records are critical to these efforts. They can let providers know that a patient has already received a test so they don’t have to have it done twice. They can remind surgeons of the simple follow-up tasks like ordering lab tests or antibiotics that can significantly reduce the chance of complications.

They can help teams of doctors, nurses, nutritionists and counselors coordinate care. And they can empower patients, allowing them to access to their health information without calling up five different doctors’ offices.

Across the country, hospitals and health professionals are showing how electronic health records can lead to improved care. Earlier this year, I visited the neonatal ward at Cincinnati’s Children’s Hospital. They told me they had gone 1,000 days without a serious safety incident – a record they credited to their use of health IT.

In the long-term, electronic health records will also make it much easier to gather the data that will allow us to measure – and improve – health outcomes. For example, the information stored in millions of electronic records around the country will help us quickly and cheaply compare treatments to see which work best. Those same records, connected together, can then spread that knowledge at the speed of light throughout our health care system.

So in the Obama Administration, we look at health IT not just as an opportunity to grow our economy, but also as a powerful tool to improve health. That’s why we’ll keep working to support these technologies in the years to come. But we also need your help.

First, we need you to be part of the conversation about improving health care in America. Health reform needs health IT. But health IT also needs health reform. Ultimately, the market for electronic health records will be determined by how useful they are to clinicians and hospitals. And that will depend on the success of reform.

If health care providers are rewarded for delivering higher-quality care, they’ll be more interested in technologies that help them measure and improve quality. If there are incentives to avoid medical errors, a health record that can help prevent those errors becomes that much more valuable.

So if we want electronic health records to spread, we need you to be more than advocates for technology. We need you to be advocates for the kind of health care system that allows this technology to make the biggest impact.

Another area where we need your help is reaching out to the 70 percent of America’s doctors and nurses who belong to small practices. Switching from paper to electronic records is never easy. But it’s a lot harder for the small practice with limited staff and resources than it is for the major hospital with a trained IT team and a big budget for capital improvements.

We in the federal government are working hard to reach small practice providers, especially through the 62 Regional Extension Centers now operating around the country. But industry can play a key role too, whether it’s offering financing options to reduce the up-front cost or providing better follow-up support after you make a sale. We already have a health IT gap in this country, with the average large, urban hospital way ahead of the average small, rural practice. If we want all Americans to enjoy the benefits of electronic health records, we need to close that gap.

Finally, we need to make sure that the adoption of health IT doesn’t contribute to another gap in our health care system: the racial, geographic, and socioeconomic disparities in care that unfortunately are far too common in our country. We need vendors to develop, sell and support products that clinicians who serve our most vulnerable populations can afford and use. It’s unacceptable for this powerful new health tool to serve some Americans better than others.

Here at HIMSS, we can get a glimpse of a future in which electronic health records are fully integrated into our health care system. We could have ambulances equipped with hand-held computers that EMTs use to update a health record that ER clinicians can read even before the patient arrives. We could have mobile applications that remind patients to take their medicines, check their blood sugar, or get their preventive tests – and then send an update right back to their doctor or nurse’s computer.

Today, these possibilities can seem far away, but I feel confident that someday these will be common features of our health care system. Eventually, hospitals will clear out their file cabinets. There will be some new generation of Americans that won’t understand what people mean when they joke about doctors’ handwriting.

The questions that remain are: how long will Americans have to wait to enjoy the benefits of these technologies? And will those technologies will be developed and built here in the US or overseas? The answers to those questions will be determined by how we take advantage of the opportunity we have in the coming years.

I believe that if we build on the partnerships that we’ve established in the last forty-eight months – and if we push forward in the areas I identified – that we can make more progress on health IT as a nation in the next five years than we have in the last fifty.

That would be an extraordinary technological achievement. But more importantly, it would be a giant step towards a healthier, more prosperous future for all Americans.

So in the months to come, I hope that you’ll continue to work with us to accelerate the development of a national health IT network that will mean better tools for doctors and nurses, better care for patients, more control for consumers, and new jobs for our economy. We’ve come this far together. Now, let’s finish the job.