Medpage today reported that in yesterday's Senate approval of the stimulus package, that $19 Billion dollars would be allocated to health IT. According to the MedPage report, "The Senate bill allocated about $19 billion to upgrade hospitals' electronic records systems and limited how much an individual hospital could receive to $1.5 million."
Granted, this is only about 2% of the entire stimulus bill, but $19 billion is a lot of money. I am all for improving health IT, but is this where we want to spend the money? I am just a doctor, not a politician, political pundit or economist; so maybe I don't understand the stimulus plan. I thought that the point of the stimulus plan was to create jobs and help people. Since there are several proprietary products on the market, it is unlikely that spending on health IT will create a lot of extra jobs, but rather sell a lot of softwared and some hardware. More importantly, who is the health IT spending helping?
There are 7,569 hospitals in the US. That comes to roughly $250,000 per hospital, though not every hospital gets the same amount (and there is a limit of $1.5 million for an individual hospital). That's a lot of money. Do we really want to give a quarter of a million dollars to each hospital to improve their health IT? Many hospitals already have their own electronic medical records? Do they really even need this? What about the 20% of the hospitals that are for profit, are they getting some of this money?
There is no question that Health IT will substantially improve the quality of care delivery in this country, and in the long term is a worthwhile investment. The real question is how and where should we invest? I would argue that the hospitals are not the best place to go. Fortunately, most Americans with health problems are not in the hospital. Certainly hospitalized patients comsume more health care dollars, but there is no good evidence that health IT actually saves money. Would it not be better to invest in Health IT that actually keeps patients out of the hospital? In addition, as mentioned, many hospitals already have an electronic medical record/electronic ordering, whereas most practicing physicians (especially primary care) do not have an EMR. Would it not be better to give $85,000 to each primary care physician to set up his or her own EMR? Better yet, use the money to come up with a system that actually works, is easy to use and distribute, improves quality of care for all and decreases costs?
Health IT is important, and should be an important part of health care reform. However, giving $19 Billion directly to hospitals to beef up systems that many already have is not money well spent.