| David McClure, president and chief executive officer of the U.S. Internet Industry Association (USIIA), Aug. 14 recommended six legislative and regulatory policies that the nation must adopt before "e-Health" services can reach their full potential.
McClure outlined the results of his study to reporters in a conference call, where he described e-Health services as the convergence of telemedicine, or clinical diagnoses, and the administration of health care services.
"What we specifically wanted to look at is, how can we as a broadband industry work together with policymakers to begin to realize some of what we're seeing as the growth of e-Health services," McClure said.
The benefits of telemedicine are already well recognized, with numerous pilot programs underway, McClure said. "We also determined that there are some real problems," he said. Specifically, problems with administration, high costs, and reaching patients in rural and remote settings, he said.
The study tried to find solutions to some of these issues, resulting in six legislative and regulatory goals, McClure said. The policies are aimed at increasing broadband penetration as well as promoting e-Health.
More Public/Private Partnerships.
The first goal is the adoption of more public/private partnerships, McClure said. There has been much discussion about the use of federal funds to directly support e-Health services, but in reality, there needs to be more private support, he said.
McClure pointed to the ConnectKentucky example, which has taken that state from 60 percent broadband penetration to more than 90 percent penetration in just a few years. "So we see more of those public/private partnerships as being critical," he said.
Second, reform of the Rural Utilities Service broadband loan program is still necessary, McClure said. Just recently, RUS has been moving aggressively to reform that program, he acknowledged.
The program has been effective in doubling or tripling broadband coverage in some rural areas, McClure said. However, it has not been as effective as it could be, because the loans have been going out to places where there is already private capital being invested, he said.
Third, there is a need for more incentives to adopt administrative and clinical solutions, McClure said. Specifically, incentives to health care providers to reduce operating and administrative costs through document management and storage, he said.
Most prescriptions are still written by hand, as are medical records and charts that are stored in a room inaccessible to anyone outside of that doctor's office, McClure said. "Document storage and retrieval capabilities I think are going to be really critical and broadband's going to play an important role there," he said.
Financial Incentives Needed.
Fourth, other obstacles to deploying health services include how to pay for these services, McClure said. The medical industry is large, bureaucratic, and entrenched in the way it operates, he said. It does not see a lot of financial incentive to move to new technology, despite the well-documented benefits, he said.
"We've got to have some means of encouraging them and incentivizing them to make those investments for the good of the medical industry and for the good of consumers," he said.
Fifth, there needs to be a leadership role by the federal government to promote health information technology (IT) adoption, McClure said. There have been some piecemeal efforts by lawmakers to introduce bills, but there needs to be a more concerted federal effort.
Among them, a statute that makes the federal government responsible for leading public/private processes, standards for system interoperability, product certification, quality measurements, and federal financial incentives for practitioners to adopt health IT, McClure said. There is also a need for communities, states, and other entities to plan health IT products and services. Further, there needs to be a federal focus on consumer empowerment through patient education tools, he said.
Even more than interoperable systems, what is needed are processes where industry, consumers, and regulators can comment, get feedback, and propose a standard, McClure said. This can take months or years, but at the end there is a standard that has general agreement among consumers and industry, he said.
If this process involves both the communications industry and the medical services community, the result will be a faster, more effective standard, McClure said.
No Net Neutrality.
A possible sixth, or final, recommendation is not passing so-called net neutrality legislation, McClure said. "One of the things that absolutely would be detrimental to the adoption of e-Health services nationwide is if we were to pass regulations that in some way prohibited networks from prioritizing traffic," he said.
E-Health services cannot advance if critical patient data that must be transmitted must compete with general Internet traffic, downloads from YouTube, or peer-to-peer sites, McClure said.
"We need to have the ability to prioritize e-Health services as we do other emergency communications across the networks. And legislation, for whatever reason, that would act to the detriment of that prioritization could have a really dampening effect on the adoption of e-Health services because they simply wouldn't be effective," he said.
No New Privacy Laws.
When asked if additional legislation is needed to address privacy or security issues related to the transmission of health data, McClure said no.
McClure said care always needs to be taken when dealing with the privacy of data transmissions. "But it's not like this isn't anything we don't face anywhere else. We have the same kind of privacy issues when we talk about your financial data from your bank, and we seem to manage that quite effectively," he said.
It is not that the nation needs more laws passed to safeguard health data; rather, the laws that are already enacted must be enhanced, McClure said. "I think it's very easy for us to go awry in our concern over privacy issues," he said.
This is shown, for example, in the implementation of the Health Insurance Portability and Accountability Act of 1996, which now prevents some personal caregivers who are not direct family members from accessing medical information that they may need to give care.
"You have to be very careful when you look at boldly stepping forward to pass new privacy laws," he said.
By Cheryl Bolen
The study, "e-Health and America's Broadband Networks," is available at http://www.usiia.org/pubs/eHealth.pdf .
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