What the presidential election could mean for health IT

Given the bipartisanship surrounding health IT for years, it's no surprise that both presidential candidates back the use of IT to improve healthcare.

The Obama administration is a strong supporter of the meaningful use incentive program and has worked to significantly increase the transparency of federal health data. In a Presidential Message issued during National Health IT Week in September, President Obama wrote, "Modernization of America's healthcare system is essential to the well-being of our people in the 21st century," adding, "Continued technological advances in how medical information is shared will be key to helping healthcare providers and patients make more informed decisions."

Meanwhile, GOP presidential nominee Mitt Romney backed several health IT initiatives when he was governor of Massachusetts, including regional health IT pilot programs to study the effectiveness of broad implementation of electronic health records and the launch of a website to let consumers compare the cost and quality of hospitals across the state. And, the American College of Physicians notes that Romney has said that he "supports efforts to facilitate information technology interoperability."

Further, both the Democratic National Committee and the Republican National Committee included brief mentions of support for health IT in their party platforms.

Despite these similarities, there are some differences when it comes to Republicans' and Democrats' strategy on health IT policy.

Dave Roberts -- vice president of Government Relations at the Healthcare Information and Management Systems Society (HIMSS) -- noted that "we've seen great interest in health IT" from the last two presidential administrations. But, there were differences in that support. "The Bush administration provided leadership, but not federal funding," while the "Obama administration has provided both leadership and federal funding to jumpstart transforming healthcare using IT," he said.

If Obama is re-elected, federal health IT efforts likely will continue on their current path. However, it's less clear what would happen under a Romney administration.

Roberts said, "For the presidential race, there has not been a lot of discussion on this topic from the [Romney] camp."

Jennifer Covich Bordenick, CEO of the eHealth Initiative, said, "It's difficult to say with Romney because we know what he did in Massachusetts, but he's not proposing that on a federal level. So it's difficult to try to interpret what that means for him. He hasn't been very specific about that."

Because the Romney campaign has been relatively mum when it comes to specific health IT policy, the industry has been left to speculate on how the election might affect health IT initiatives. Could the meaningful use program be on the chopping block? Would federal health data transparency efforts continue?  If efforts to repeal the Affordable Care Act (ACA) succeed, what would that mean for health IT firms? And, how would the federal health IT leadership be affected?

Meaningful use incentive program
Depending on the outcome of the presidential and congressional elections, it's possible that there could be efforts to end or alter the meaningful use incentive program.

Roberts said, "We do hear that some members of Congress are currently talking about possibly not continuing the incentive program." However, he noted that it would be "very difficult to end the incentive program."

Because the meaningful use program is classified as an entitlement, Congress would have to pass legislation to end or reduce the program.

Roberts said, "First of all, you have to have a new president [who] would want to change it and really show why you'd want to change a program that seems to be doing well," adding, "You then have to look at the makeup of the U.S. Senate and the U.S. House, and could you get a piece of legislation through both bodies so the president could sign it?"

Roberts also noted that "because of the scored savings" associated with "implementing IT to improve healthcare," Congress "would have to come up with offsets."

Although the likelihood of lawmakers ending the meaningful use program is small, HIMSS isn't taking any chances. The organization has prepared fact sheets for every district and every state, showing how much meaningful use funding has gone to each state and offering information on EHR adoption.

Roberts said, "We're trying to show all members of Congress how meaningful use has helped their district and their state."

Health data transparency
The Obama administration has made health data transparency a priority. In a September 2011 iHealthBeat Perspective, then-HHS Chief Technology Officer Todd Park wrote, "HHS has begun 'liberating' health data through the Health Data Initiative -- making more and more data from HHS' vaults (from CMS, CDC, FDA and NIH, to name a few sources) easily available and accessible to the public and to innovators across the country."

Park -- who now serves as the U.S. CTO -- added, "Our goal is to unleash the power of private-sector innovators and entrepreneurs to utilize HHS data to create applications, products, services and features that help improve health and healthcare."

Romney "has been very quiet" on the issue of health data transparency, according to Roberts.

However, he said, "I think consumers are going to want to continue these efforts. We are in an information age, and they want transparent data, they want access to information. And, I think no matter who is president that you're going to see a lot of these efforts going on."

Covich Bordenick agreed, saying, "I think that definitely healthcare transparency is here to stay." She does not think that consumer websites and HealthData.gov "would be greatly affected" by the election. Covich Bordenick said, "I would hope that whoever is elected is going to continue to encourage the use of these tools for patients."

Effect of an ACA repeal
The Affordable Care Act has remained a hot topic in the presidential campaign. Romney has vowed to repeal the federal health reform law if elected, while the Obama camp continues to promote some of the law's most popular provisions.

While the meaningful use incentive program is completely separate from the ACA, the law contains several health IT-related provisions, such as the health insurance exchanges and accountable care organizations. So it's possible that a successful repeal of the ACA could have a trickledown effect on the health IT industry.

Covich Bordenick said, "I don't know how possible it would be to repeal [the ACA]. The experts say it's not very likely." However, "The threat of that is real and just the fact that [Romney] just has staunch opposition to it, you can tell it would definitely impact the administration."

Roberts said, "I'm very involved with a number of health systems. I talk to their CEOs, their CIOs, and they just do not like the uncertainty. They want to understand what's going to happen so they can make investment decisions on where they're going to take their health systems."

Federal health IT leadership
If Romney wins the presidential election, it's possible that federal health IT leaders such as Park and National Coordinator for Health IT Farzad Mostashari would be replaced.

Roberts said, "Political appointees serve at the will of their appointer, and I think that many people would agree across party lines that Dr. Mostashari and Todd Park have done a great job in their respective positions." He added, "But a new president likes to bring in his own people, and so if there were a new president, he would be considering other people that were more closely aligned with him to do some of these critical jobs."

Covich Bordenick said that "it's just difficult to say" how the federal health IT leadership would be affected under a new administration. She said that whenever you change leadership, there are "going to be some bumps in the road," but she said that "regardless, the industry will continue to move forward."

This article originally appeared on iHealthBeat. It is republished here with permission from iHealthBeat.


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