Gingrich: Electronic health records needed faster

BALTIMORE, MARYLAND - U.S. hospitals, doctors, insurance companies, and the government are endangering lives by moving too slowly in adopting electronic health records, Newt Gingrich, former speaker of the U.S. House of Representatives, said Wednesday.

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Gingrich, now running a health-care advocacy group called the Center for Health Transformation, challenged attendees of the Workgroup for Electronic Data Interchange's (WEDI) annual convention here, to push for higher standards in health care and to promote electronic health records. Electronic health records are the first step toward what Gingrich called a "21st century intelligent health system," which would make an electronic health record and instant diagnostic tool available to all U.S. residents.

WEDI is a trade group that advocates improved health care through electronic commerce, and Gingrich, along with Tommy Thompson, former U.S. secretary of health and human services, received the organization's annual innovator's award. This month, Republican Gingrich joined with former political rival Senator Hillary Clinton, a Democrat from New York, in supporting a congressional bill aimed at jump-starting electronic health record use in the U.S. Gingrich and Clinton both are mentioned as possible U.S. presidential candidates in 2008.

In January 2004, U.S. President George Bush called for the adoption of standards for electronic health records. But Gingrich said adoption is moving to slowly.

A 21st century intelligent health system, which U.S. residents could voluntarily access, would include DNA tests that alert individuals to health risks, Gingrich said. The system could include a home diagnostic kit, with features such as blood testing equipment, that a person could administer to themselves and get a near-instant diagnosis or warning to see a doctor, he said.

"We have to have a sense of urgency," Gingrich told WEDI attendees. "Every day we don't get that data to the people who need it, they die."

Internet users can instantly buy airplane tickets online or drivers can pay for gas instantly using a passcard at a gas pump, but the U.S. health-care industry still largely relies on paper-based records to track patient treatment, he said. "This is normal outside of health," he said of electronic transactions. "We're not asking health to be innovative, we're asking health to catch up. We're not taking about the distant future, we're talking about the recent past, integrated into health."

Gingrich, who served on an aviation committee when he was in Congress, compared health-care patient treatment standards to aviation safety standards. In the aviation industry, "best practice is the minimum practice," he said, while in health care, an estimated 8,000 U.S. residents die every year from medication errors. Many in the health-care industry just accept those deaths, but many of those deaths, along with tens of thousands of other deaths related to other medical errors, could be greatly reduced with electronic health records that check for conflicting medications or treatments, he said.

"If we lost 8,000 people in aviation, we'd have a crisis," Gingrich said.

Gingrich also called for a national law requiring physical education class five days a week for high school students, as a way to prevent obesity and diabetes, and he called for tax credits and Medicaid program vouchers as a way to move all U.S. residents to insurance coverage.

Republicans in Congress defeated a national health-care plan advanced by Clinton in the early 1990s, when she was U.S. first lady, but Gingrich said Wednesday 100 percent insurance coverage is needed in the U.S. He called the U.S. insurance system, where insurance companies can choose to cover the healthiest people, "stunningly irrational."

Efforts to convert government health-care services to electronic health records have met resistance, Gingrich said. When he's asked Medicare officials to convert so that the government health insurance program for retired people can be ready for retiring baby boomers, those officials have dragged their feet, he said. Paper medical records don't make sense for baby boomers, many of who will travel during retirement and live 20 or 30 years after retiring, he said.

Government officials and some insurance companies have been slow to see the long-term benefit of a small up-front investment in new technology such as electronic health records, he said. Converting to electronic health records would save the larger cost of faxing and updating millions of baby boomers' paper medical records over 20 years, he said.

While Gingrich talked of the benefits of electronic health records, other speakers at the WEDI conference spoke of difficulties with the transition away from paper. Many hospitals and doctor's offices are still lacking in information security, physical security and privacy protection practices that will be needed with electronic health records, said David Ginsberg, a privacy law consultant for the California Medical Association.

"If the back door is left open all the time, and the front door has a crappy lock, what good are all your controls, if someone walks off with your computer?" he said.

Ginsberg also warned health-care facilities to compare and test electronic health record systems before spending tens or hundreds of thousands of dollars to convert from paper. No standard platform exists yet for electronic health records, and some packages try to force doctors to drastically change the way they work, he said.

"Now you're asking physicians to change their workflow habits," Ginsberg said. "That doesn't happen easily."