The market has already begun to beat the government to the game on electronic health records:
"We're a high-volume, low-cost company," said Marcus Osborne, senior director for health care business development at Wal-Mart. "And I would argue that mentality is sorely lacking in the health care industry."
The Sam's Club offering, to be made available this spring, will be under $25,000 for the first physician in a practice, and about $10,000 for each additional doctor. After the installation and training, continuing annual costs for maintenance and support will be $4,000 to $6,500 a year, the company estimates.
Wal-Mart says it had explored the opportunity in health information technology long before the presidential election. About 200,000 health care providers, mostly doctors, are among Sam Club's 47 million members. And the company's research showed the technology was becoming less costly and interest was rising among small physician practices, according to Todd Matherly, vice president for health and wellness at Sam's Club.
The financial incentives in the administration plan--more than $40,000 per physician over a few years, to install and use electronic health records--could accelerate adoption. When used properly, most health experts agree, digital records can curb costs and improve care.
The only potential downside to this will be that many medical practices may have security issues because they won't have IT staffs keeping their networks and machines up to date and configured to fight the latest known security problems. The physicians who buy these packages need to make sure that a key part of the support package that they are buying is labor to get their infrastructure secured. For many, that may be as simple as keeping it unnetworked, as it probably should be, but for the sake of their practice, they need to make sure that there is an obligation to secure all of the affected equipment.
Whatever the technical merits and issues are, the momentum is clearly moving in this direction. The Obama Administration has made a federal case out of the cost of health care, and the market is starting to respond aggressively. The best thing that privacy advocates could do now is to stop fighting the transition, and start focusing on fighting the legislative and court battles against the privacy issues that will arise in the near future.
There are still some unresolved technical issues that will probably get resolved by legislative "solutions." Transferring records from provider to provider will be a contentious issue, and the federal government is going to try to regulate that from the network layer, up to the administrative staff level. There is also not a consensus on how to store medical data, so medical data will have to be transformed from one format to another, and that will create potential legal liability issues from both privacy and accuracy issues. It is simply naive to assume that these are issues that the government will take a laissez faire approach to, given the performance of both major parties on regulation.
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