Drawing rare and rapid support from both sides of the Congressional aisle and wide agreement from healthcare organizations, a bill introduced in mid-May looked by early June to be headed for quick passage in the 109th Congress. The 21st Century Health Care Information Act, introduced by Rep. Tim Murphy (R-Penn.), and cosponsored by Rep. Patrick Kennedy (D-R.I.), promotes creating more regional healthcare information networks that showcase interoperability of medical record software. Also, Sen. Hillary Clinton (D-N.Y.) said she was working with former speaker Newt Gingrich (R-Ga.) on a companion to the House bill that would “spur the adoption of electronic record-keeping applications.”
When introducing his bill, Murphy underscored the need for action by reporting several findings: Lab and radiology results and medical histories were missing during 13.6 percent of patient visits in a recent JAMA study; improper medications are prescribed in about one of every 12 physician visits, per a CDC report; and patients receive recommended care only about 55 percent of the time, according to a Rand Corporation investigation. Murphy also pointed out the need for a more coordinated national effort, citing that 32 states and the District of Columbia have funded healthcare IT initiatives and that 23 federal agencies have adopted standards for electronic exchange without coordination with private industry or individual states.
Murphy’s House legislation (H.R. 2234) would give the Department of Health and Human Services (HHS) Secretary the authority to award up to $50 million total in 20 grants in fiscal 2006 to help establish interoperable regional health information networks and promote the adoption of IT products. It also authorizes similar spending on regional health information organizations (RHIOs) grants in each fiscal year from 2007 through 2010. The law would require RHIOs that receive federal grants to utilize federally-certified healthcare IT products. The overseeing federal agencies will have approval rights if an IT certification process is not yet in place by the time the projects are implemented, in 2006 or 2007.

RHIOs have been taking root across the U.S. since late 2004, when federal seed money helped establish five programs (in Colorado, Indiana, Rhode Island, Tennessee and Utah) to demonstrate exchange of health data among systems with varying software products. Many RHIOs, including new ones in California and Massachusetts, have sprung up without help of federal funds.

In May, Massachusetts formally launched three large-scale regional health IT pilots in Brockton, Newburyport and northern Berkshire. Led by not-for-profit Massachusetts eHealth Collaborative, it is also funded in part by $50 million from Blue Cross Blue Shield of Massachusetts. Also in May, CalRHIO, a statewide network managed by the non-profit Health Technology Center, announced it would electronically link state emergency departments and ultimately permit transfer of patient data between labs, pharmacies, hospitals and physician offices.

Murphy’s bill earned favor from many physician organizations including the American Academy of Family Physicians, the American College of Physicians and the American Health Care Association. The bill directs AHRQ (Agency for Healthcare Research and Quality) to create a National Technical Assistance Center to assist physicians, financially and technically, and to give priority to small practice.