American Recovery and Reinvestment Act of 2009

Floor Speech

AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009 -- (Senate - February 06, 2009)

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Mr. KENNEDY. Mr. President, as we consider the provisions of this legislation that provide significant incentives for the adoption of health information technology I would like to take this opportunity to explain a seemingly technical element of the language. The term ``qualified electronic health record,'' as defined in section 3000 of the Public Health Service Act, as added by section 13101 of the American Recovery and Reinvestment Act of 2009 is intended to include computerized provider order entry systems. Such systems are electronic records of health information on an individual. They include patient demographic data and health information, such as medical history and problem lists, including patient age, gender and allergy information as well as laboratory reports. Computerized provider order entry systems also have the capacity to provide clinical decision support such as medication dosing and interaction alerts, to capture and query information related to health care quality such as changes in laboratory values, and responses and reaction to medications, and to exchange electronic health information with, and integrate such information from other sources such as medication lists from a pharmacy or clinical information from a provider practice. Of course, the end goal is development and implementation of comprehensive, integrated electronic health records, and computerized provider order entry systems are an important intermediate step.

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HEALTH INFORMATION TECHNOLOGY

Mr. HATCH. Mr. President, I would like to ask a question through the Chair to my good friend from Massachusetts, Senator Kennedy. Is my friend aware that the legislation before us today, the Economic Recovery and Reinvestment Act of 2009, contains a provision which would establish the Office of the National Coordinator for Health Information Technology within the Department of Health and Human Services and instruct the National Coordinator to support and facilitate the use of electronic health records for Americans?

Mr. KENNEDY. That is correct. There are a few provisions in the legislation that address this issue directly. Subsection 3001(c)(3)(A)(ii) of the bill tasks the national coordinator with updating the Federal Health IT Strategic Plan to include specific objectives, milestones, and metrics with respect to ``the utilization of an electronic health record for each person in the United States by 2014.'' Subsection 3001(c)(6)(E) requires the national coordinator to ``estimate and publish resources required annually to reach the goal of utilization of an electronic health record for each person in the United States by 2014, including the required level of Federal funding, expectations for regional, State, and private investment, and the expected contributions by volunteers to activities for the utilization of such records.'' In addition, subsection 3002(b)(2)(B)(iii) of the bill designates the Health Information Technology Policy Committee with the task of making recommendations to the national coordinator for the ``utilization of a certified electronic health record for each person in the United States by 2014.''

Mr. HATCH. It will come as no surprise to anyone to know that many Americans will be skeptical of the creation of a national database and central repository of health records. Indeed, one group which is particularly concerned with this provision would be those who do not use medical treatment or interact with the health deliver services in this country. Therefore, I would again ask my friend, through the chair, does the language in these subsections attempting to establish ``the utilization of an electronic health record for each person in the United States by 2014'' require those who do not use medical treatment to go to a doctor for a physical examination in order to have an electronic health record created?

Mr. KENNEDY. No, it does not. Nothing in this bill should be interpreted as requiring those who do not use medical care to have an electronic health record, or requiring any individual to have an electronic record. The intention is that the national coordinator will work towards the goal of having all patients that utilize the services of ``health care providers,'' as defined in this act, to have available to them records in an interoperable electronic format instead of merely in paper form by the year 2014. Those who do not receive care and services from ``health care providers'' will not be required to have an electronic health record, nor will any individual be required to have an electronic medical record. This bill does not require the use of electronic medical records, but seeks to make such records more broadly available.

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