Regardless of whether she wins the Democratic Party's nomination, Clinton has placed healthcare at the top of her domestic agenda and therefore, her challengers have had to make it a priority for their campaigns as well. Had she not entered the race, healthcare would not be the highly publicized issue it has become. While most of the talk has centred on universal health insurance, healthcare technology has also been addressed as a way to improve the US healthcare system. In the aftermath of Super Tuesday, three leaders have emerged – Clinton, Barack Obama and John McCain. All three have cited healthcare technology in some respect in their plans for healthcare reform.
Clinton plans to “institute a new ‘paperless' health information technology system” to improve quality of care and decrease costs. She would provide financial incentives as well as funding, “an up-front and phased-out $3 billion a year,” for providers to adopt healthcare IT. Additionally, Clinton would champion computerized physician order entry (CPOE) and require providers taking part in Medicare and Medicaid to use technology in their practices. $50 million in government funding would also be set aside to place more information on hospitals and physicians online, giving patients the information they need to choose the best quality care available to them. Clinton's recognition that aligning financial incentives, creating regulations for government programs and increasing transparency will aid healthcare technology adoption and benefit healthcare as a whole are testaments to her understanding of the underlying problems in healthcare.
Obama, arguably the most technologically savvy of the candidates with his proposed technology and innovation policies, has also included a plan to invest in electronic health information technology systems. Not only does he intend to spend “$10 billion a year over the next five years” on healthcare IT, he actually refers to electronic health records (EHRs), specifically, in his plan. He also cites the Veterans Health Administration's IT system as a model for other healthcare systems. While these points sound impressive and are most definitely ambitious, Obama does not seem to have additional specifics for his plan on healthcare IT and Datamonitor is sceptical that $50 billion will suddenly be available for healthcare IT if he is elected.
McCain vaguely calls on “promot[ing] rapid deployment of 21st century information systems” in healthcare without citing EHRs or additional funding. However, his plan is refreshingly unique in that it gives a nod to telehealth (which he refers to as telemedicine), a technology that European countries have seen the value in, but is not talked about as much in the US. Not only does he encourage the use of telehealth, but he also goes a step further by recommending that providers be able to practice nationwide. This policy would enable clinicians using telehealth to gain the full benefits of the technology by allowing them to practice across state lines.
All three leading candidates have included healthcare technology in their platforms, which is a major accomplishment for healthcare IT as whole. Regardless of who is elected, technology will play a role in the next President's healthcare agenda. If Clinton wins, she will look to use healthcare IT in a comprehensive manner to solve underlying healthcare problems. Obama will seek to provide substantial funding for EHRs. Telehealth could be McCain's focus. If universal health insurance is pursued in the next four years, healthcare IT will play just as much of a role in that system as it does in today's environment.
However, the candidates' plans are still a far cry from the idealized national network the healthcare IT community has imagined and, of course, there's no guarantee that if any one were elected they would be able to deliver on their proposals. The focus on universal insurance could also overshadow healthcare technology. The US already has Presidential support on healthcare IT adoption with President Bush's goal for most Americans to have an EHR by 2014 and his proposal to increase the Office of the National Coordinator for Health Information Technology's budget from $61.3 million in 2008 to $66 million in 2009. As the healthcare community has seen in the past few years, government support is not the only barrier to IT adoption; healthcare providers have yet to fully embrace and understand technology and the solutions themselves could still be improved. The healthcare community has bi-partisan support for continued investment in IT, now it must focus on these other barriers to technology adoption.
