The Senate Health, Education, Labor and Pensions Committee on Thursday held a hearing on the inclusion of health information technology funding in the economic stimulus package, CongressDaily reports. The House's $825 billion economic stimulus package includes $20 billion for health IT. At the hearing, Sen. Barbara Mikulski (D-Md.) warned against moving too quickly on similar Senate legislation. She added that health IT legislation should be "patient-centered and patient-secure" and should facilitate interoperability. Mikulski also noted that about 4% of U.S. physicians currently use electronic health records, but failure to make those records interoperable between hospitals and other health care facilities has affected efficiency and patient care.

Jack Cochran, executive director of the Permanente Federation, testified at the hearing that health IT implementation could be disruptive and would not produce savings for several months. Janet Corrigan, president of the National Quality Forum, and Valerie Melvin, director of IT at the Government Accountability Office, both called for set standards for IT.

Mikulski said that the Senate Appropriations Committee's mark up of the economic stimulus bill likely would occur before February. She declined to say whether the Senate version of the bill would include the health IT provision included in the House's version (Noyes, CongressDaily, 1/15).

New York Times Examines Privacy Protections
President Obama's plan to expand the use of health information technology systems could be "imperiled by a bitter, seemingly intractable dispute over how to protect the privacy of electronic medical records," the New York Times reports. Obama in a recent speech about the economic recovery plan said, "We will make the immediate investments necessary to ensure that within five years all of America's medical records are computerized." He said that electronic health records could prevent medical errors, save lives and create hundreds of thousands of jobs.

However, lawmakers, "caught in a crossfire of lobbying by the health care industry and consumer groups, have been unable to agree on privacy safeguards that would allow patients to control the use of their medical records," the Times reports. Consumer advocates and some lawmakers "insist that the new spending must be accompanied by stronger privacy protections in an era when digital data can be sent around the world or posted on the Web with the click of a mouse," according to the Times. Reps. Edward Markey (D-Mass.) and Pete Stark (D-Calif.), and Sens. Patrick Leahy (D-Vt.) and Olympia Snowe (R-Maine) have been leading efforts to include privacy and safety provisions in the stimulus package. Markey has said that without the safeguards, health IT networks could turn into "a nightmare for consumers" using them.

Meanwhile, insurance company lobbyists, pharmacy benefit managers and others in the health care industry are working "to persuade Congress that overly stringent privacy protections would frustrate the potential benefits of digital records," the Times reports. America's Health Insurance Plans CEO and President Karen Ignagni in a letter to congressional leaders said the group is particularly concerned about a proposal that would require health care providers to obtain patient consent before disclosing personal health information for treatment, payment or "health care operations." She said such a requirement could hurt efforts to manage chronic diseases that often require coordinated care from multiple specialists. Insurance company lobbyists said they hoped Congress would not include privacy standards in the stimulus package, but defer the issue to HHS.

Other safeguards proposed by privacy experts and advocates to ensure the safety and confidentiality of patient health records include allowing patients to designate access to specific or sensitive information, such as data on psychotherapy treatments, abortions and HIV tests; mandating the use of encryption technology to protect EHR information while it is stored or transferred between computers; requiring health care providers to notify patients of any unauthorized acquisition, access or disclosure of medical records; and allowing patients to recover damages from an entity that improperly used or disclosed personal health information.

Advisers to Obama say that the president supports strong privacy protections but does not want the issue to slow approval of the stimulus package (Pear, New York Times, 1/18).