The bill that might become the House of Representatives' focus for action on electronic health record issues got an airing at a March 16 subcommittee hearing.
Introduced by the chairs of the two major House health subcommittees, H.R. 4157, would, among other things, initiate a course that might end with federal health privacy laws pre-empting state laws, to create a uniform standard.
The legislation would also put into law a plan to create "safe harbors" to allow hospitals and other entities to give physicians computer items and expertise, in order to encourage use of electronic records. The Department of Health and Human Services (HHS) has already proposed that sort of change, but this bill would further formalize it into law.
Privacy top of mind
However, the privacy provisions are probably attracting the most attention at this point. The House legislation would mandate that HHS do a study of state and federal laws affecting health privacy. At that point, the department would send Congress a report on whether there should be national uniform standards and, if so, what they should be. Then, if Congress did not act within three years, the HHS-recommended standards would become law.
For More Information...
The House and Senate bills are available at http://thomas.loc.gov. The testimony on the House bill, including some of the technical recommendations, may be available on the committee's site at http://energycommerce.house.gov., under "Hearings and Markups."
William Vaughan, senior policy analyst for Consumers Union, objected at the Energy and Commerce health subcommittee hearing, saying privacy laws still need to be strengthened, and, "States should have the right to enact privacy laws above and beyond HIPAA's absolutely minimal provisions and that right must not be pre-empted."
On the other hand, Mark Neaman, president of Evanston (Illinois) Northwestern Healthcare and chair of the Healthcare Leadership Council, informs the subcommittee in his written testimony that the significant state variations in privacy standards allowed under HIPAA "create serious impediments to interoperable electronic health records, particularly when patient information must be sent across state lines."
"State health privacy protections vary widely and are found in thousands of statutes, regulations, common law principles and advisories," writes Neaman.
The legislation would also mandate the existence of the Office of National Coordinator for Health Information Technology, which currently exists in HHS and was headed by David Brailer, M.D., Ph.D. until his recent resignation.
Two bills on the table
The Senate passed a health information bill last November, the "Wired for Health Care Quality Act" (S.1418), but the two pieces of legislation are very different. The Senate bill would establish various sorts of financial assistance for providers to adopt electronic health records. But, in contrast to the House bill, it would not codify the plan to create safe harbors to encourage hospitals and others to donate equipment and other items.
The Senate legislation would create a best practices center to help professionals learn from each other in setting up networks, as well as a help line to answer technical questions. It would also require the development of interoperability standards, something HHS is working on.
A Senate staff aide working with the legislation says if there is to be a health information technology bill passed this year, it may happen by two dissimilar bills going to conference committee between the two houses, and major compromises being worked out there.
Since Congressional elections are coming this fall, Senate staff says the hope is to get bills moving in the next few months, before the campaigns begin to take up so much of members' time.
Kathryn Foxhall is a freelance writer based in Hyattsville, Md.