STATEMENT
of the
Honorable Nydia Velázquez, Chair
Committee on Small Business
Full Committee Hearing on:
“Cost and Confidentiality: The Unforeseen Challenges of
Electronic Health Records in Small Specialty Practices”
Thursday, July 31, 2008

 

In the last few decades, information technology has revolutionized virtually every American industry. Today, previously complex and time consuming tasks can be easily accomplished with the click of a mouse. But-- as with any large-scale shift or system overhaul-- the adoption of new technology comes with certain growing pains. Nowhere is this more true than in our nation’s health care sector.

By the year 2014, the National Information Technology Coordinator expects the U.S. to have a nationwide network of electronic health records. Today, several bipartisan proposals supporting this network are working their way through Congress.  Both Democrats and Republicans recognize the value in HIT. After all, it promises to not only control costs, but also to improve quality. That is an especially appealing prospect, given the skyrocketing price and declining value of modern health care.  
 
In today’s hearing, we will discuss the value of HIT, and also explore the various concerns surrounding its use.

If properly implemented, HIT can streamline the flow of complex health care data. In doing so, this technology will improve communication between doctors and hospitals. And given the inherent complexities of medicine, a well-structured communication network is of the utmost importance. 

But despite growing support for health care technology-- particularly in the form of Electronic Health Records, or EHR--small practices have been reluctant to take it up. Whereas 57 percent of large care centers use EHR, only a handful of solo practitioners do. This is partially due to the high cost of implementation.
When all is said and done, the price tag of EHR installation comes to over 32 thousand dollars per physician. Meanwhile, monthly maintenance fees run close to 12 hundred dollars. By the time hidden costs have been factored in, final estimates can be 44 thousand dollars per doctor, with upkeep fees of 85 hundred dollars a month. For small health care providers with limited resources, these upfront costs are enough to break the bank.

In addition to the weighty financial obligation, a series of legal and privacy concerns have deterred small health practices from adopting HIT. As a practical matter, electronic information can be transmitted and reviewed more easily than paper files. In light of this fact, some health professionals worry that HIT holds potential for health care fraud. At the same time, others are concerned that the technology might conflict with confidentiality issues outlined in the Health Insurance Portability and Accountability Act, or HIPAA.  

Finally, some specialty doctors--like neurosurgeons and pediatricians--are unable to find appropriate HIT systems. Oftentimes this technology caters only to mainstream medical practices, leaving the smaller, more specialized businesses behind.

Health Information Technology has the potential to revolutionize American medicine. But unfortunately, a series of concerns are blocking large scale implementation. There is no silver bullet solution to America’s broken health care system.  There are, however, a number of ways to address the issue. For one, financial incentives to HIT users would help spur uptake. So would strengthening privacy regulations for health records.

As we move forward in the quest to improve health care coverage and cut costs, we can look to current technology and future innovation. And yet in doing so, we must be sure to act with caution. Otherwise, we risk jeopardizing both small providers and the health and security of their patients.

With that, I’d like to thank all the witnesses in advance for their testimony. I look forward to their insight on the matter, and now yield to Ranking Member Chabot for his opening remarks.