Monday, November 3, 2008

McCain and Obama on Healthcare IT

My blog over the past year has been silent about the Presidential campaign. Given the election tomorrow, I will write one blog reviewing the candidates statements about healthcare IT.

Both candidates have made supportive statements about Healthcare IT in the debates. To my knowledge, neither has specifically mentioned AHIC, ONC, HITSP, CCHIT, NHIN, or RHIOs. My HITSP role will continue through the change in administration until October 1, 2009, so I do not have any particular partisan bias.

How do they compare? Probably the best resource is the New England Journal of Medicine articles written by McCain and Obama.

Here's a summary of these articles, based on a text search of the word "technology"

McCain

"Quality: Strengthening health care quality requires promoting research and development of new treatment models, promoting wellness, investing in technology, and empowering Americans with better information on quality."

"We need to use technology to share information on 'best practices' in health care so that every physician is up to date."

Obama

"I am committed to making the fundamental changes necessary to modernize the system to streamline medical practice with the goal of improved patient outcomes. My plan calls for investing $10 billion per year over 5 years in health information technology. This commitment is not just financial: we will ensure that physicians have the technical support they need to implement new systems for patient records and billing. By reducing medical errors and unnecessary duplication of tests, this investment will lead to a long-term reduction in our health care system's overall cost."

"Finally, I will address medical malpractice with the central goal of preventing medical errors in the first place. Through substantial investment in information and decision-support technology and other patient-safety initiatives, we will reduce the types of medical errors and oversights that lead to lawsuits."

How about the candidate's websites?

McCain

On the front page of McCain's website, I clicked on the Healthcare Plan link on the front page. The word technology does not appear on the Healthcare Plan page.

I then used the search engine on the website to search on the keyword "technology" which yielded "no documents found". I searched on "healthcare" and got

"Error
We're sorry. There appears to have been an error with your request. Please try again or if the problem continues, please contact us.
If you were trying to connect to a McCainSpace site, you may have entered the web address incorrectly. Please remember there is no www" in a McCainSpace site. Simply replace the www with the name of the McCainSpace site (i.e.: http://SITENAME.johnmccain.com)."

Through Google I found a healthcare technology reference on the McCain website:

"Health information technology will flourish because the market will demand it."

Based on my experience in Massachusetts, I have not yet seen this market demand because incentives are misaligned - he who pays is not he who gains from Healthcare Information Technology. However, McCain's advisors may have a different experience from other states.

Obama

The second major tenent of the Obama healthcare plan is:

"The Obama plan will lower health care costs by $2,500 for a typical family by investing in health information technology, prevention and care coordination."

As an unbiased observer, this brief review of the candidates suggests that McCain's plan for Healthcare Information Technology involves letting the market drive adoption because stakeholders will demand it. Additionally, physicians will be kept up to date. Obama's plan involves a $50 billion dollar investment in decision support, reduction of redundant testing, and minimizing medical error.

Whatever your decision, get out and vote tomorrow!
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