Panel takes up debate over electronic medical records

House Energy and Commerce Health Subcommittee members and policy experts debated today how Congress can strike a balance between accelerating the adoption of a nationwide system of electronic medical records while protecting patient privacy.

Witnesses from the healthcare and information technology sectors pushed for the swift introduction of legislation, while patient advocates asked members to proceed with caution.

House Energy and Commerce Chairman John Dingell and ranking member Joe Barton circulated draft language last month that encapsulates proposals from several other measures and draws on a measure introduced last year by Rep. Anna Eshoo, D-Calif. It is similar to legislation introduced by Senate Health, Education, Labor and Pensions Chairman Edward Kennedy and ranking member Michael Enzi.

The draft bill, which includes privacy protections agreed to by Senate Judiciary Chairman Patrick Leahy, codifies the office of a health information technology coordinator, directs the HHS to set standards for electronic information exchange, and creates grant programs to spur physician adoption of health IT. It also includes an information breach notification requirement and a provision to close a loophole in existing privacy law that allows physicians to use patient records for marketing purposes.

House Energy and Commerce Health Subcommittee Chairman Frank Pallone, D-N.J., said the United States spends $2.7 trillion annually on health care, but "we don't fare better than countries that spend a lot less." He observed that citizens can monitor finances online and order a pizza with a mouse-click while the nation's healthcare regime is largely paper-based and antiquated. A national health IT imperative could save as much as $170 billion a year while improving coordination among medical facilities and improving patient care and safety, he said.

Rep. Henry Waxman, D-Calif., warned that surveys have shown consumers lack confidence in health data privacy and security, and transitioning to an electronic environment will increase that anxiety. The Bush administration has made matters worse by refusing to impose any civil fines under current medical privacy rules, added Waxman.

Witnesses included Patient Privacy Rights founder Deborah Peel, Deven McGraw of the Center for Democracy and Technology, AARP board member Byron Thames, and Steven Stack of the American Medical Association. Several called upon lawmakers to adopt a clear definition of health privacy so whatever legislation is introduced can restore Americans' trust in the healthcare system. Others argued that the nation should not have to choose between privacy fears and health IT progress.

Rep. Charles Gonzalez, D-Texas, agreed there was a sense of urgency, but called on Congress to act more quickly. "Everybody is ready to dance but the band leader has not started the music," he said. "I hope Chairman Pallone can be that band leader."