Health Care

Stimulus Bill Calls For Computerizing Health Care

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A computer screen shows medical charts for a patient, with a stethoscope lying across the keyboard.

One expert calculates that equipping hundreds of thousands of doctors with computers would create about 200,000 new jobs. Those would be in addition to jobs in hardware, software and Internet companies that let people keep their own records online. hide caption

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The economic stimulus package scheduled to hit the House floor Wednesday includes $20 billion for health information technology. The plan's overarching goal is to create jobs — and health experts say the IT provision would do that by boosting the number of physicians who use computers in their practice. Right now, only 17 percent do.

Dr. John Halamka is the chief information officer at Harvard Medical School and one of its teaching hospitals. He oversees 20,000 computers dedicated to health care.

"It requires a lot of hands on, this means you need training and education much more than hardware and software, and that means a lot of people," Halamka says.

He's helped more than 1,000 doctors in Massachusetts to go electronic, creating 20 new jobs in the process. The doctors can use computers to access patient records and order tests and drugs. And the computers can prompt them about possible diagnoses and treatments.

Using his experiences in Massachusetts, Halamka calculates that equipping hundreds of thousands of doctors with computers would create about 200,000 new jobs — positions for training health personnel and running health systems. There also would be jobs in hardware and software companies, and the growing number of Internet companies that let people keep their own records online.

That's not far from an estimate used by the Obama administration. Even opponents of the House bill say it will create jobs. Their main complaint is that the jobs won't come soon enough, given the two-year phase-in period for training.

Aside from boosting employment, supporters of health information technology say there's another benefit.

"The longer-term payoff for this investment is to have the majority, if not all, American physicians using electronic health records and producing better care," says Dr. Paul Tang, the chief medical information officer at the Palo Alto Medical Foundation. "Better care I believe will result in lower costs, so that becomes self-sustaining."

Tang and others say doctors who can look up records on a computer won't need to send patients for a second MRI if they don't have the results of the first one. The computer won't let them automatically prescribe a drug that will cause problems. Halamka estimates that by eliminating "redundant" health care — meaning repeat studies because an initial study can't be found — the savings in health costs in Massachusetts alone would be $4.5 billion.

There is some argument among economists about how much the health care system as a whole would save through computerization. According to an analysis by the Congressional Budget Office, the federal government will pay more, not less. The CBO estimates that as written, the House bill would carry $17 billion in total costs by 2019.

Some politicians and planners are concerned about pushing programs of this size through Congress so fast. James Gelfand of the U.S. Chamber of Commerce says a number of provisions need a more careful look — including how to make sure patient records are kept private while still making them available to health care personnel.

"We've been trying to find an answer for that for two Congresses now. It's been more than four years; we haven't reached a consensus," Gelfand says.

Lawmakers will have to reach some sort of consensus quickly if they want health IT in the stimulus bill. The House is expected to pass its version Wednesday, and the Senate could vote on its version soon. The self-imposed deadline for working out any differences between the two bills is mid-February.



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