tion systems in health care in contrast to many other industries. I think there are several reasons for this. One of them may be privacy concerns. As you know, there has recently been a controversial series of policy developments related to privacy issues. We are trying to go forward establishing some uniform privacy standards as soon as practicable over the next couple of years in a way that is not overly burdensome for the health care industry to implement.

Another impediment may be that the financial rewards for good information systems are not comparable to those in other industries. It is interesting to contrast the health care industry and the financial services industry. Very sensitive information is involved in both cases but I think no one would have any concerns about an ATM transaction passing across a shared network. It is handled privately. It is handled without error. It is handled with consistent standards across the board. In health care, we do not have in place either the privacy standards or the data standards or the infrastructure itself.

In terms of standards, I think the federal government is trying to move forward as quickly as we can with developing Health Insurance Portability and Accountability Act (HIPAA) and other coding terminology standards, and the establishment of the computer and data infrastructure needed to share data effectively. Again, privacy protection is an important part of this.

I still wonder whether some of these investments in computer technology are really all that promising in terms of reducing errors or delivering higher quality care. We hear a lot from hospitals and other institutions that just say, “Look, this new computer technology requires a substantial investment, and we just do not have the funds to do it.” I wonder if this is a function of reimbursement incentives that in many cases are not paying more and maybe even paying less to hospitals that deliver care without complications.

I hope that this or other groups can provide some guidance on how we can improve policies in this area. I know there are many proposals pending in Congress, ranging from grant programs to demonstration projects, to implement better computer systems. It is a critical part of health policy and innovation.



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