Federal Health IT Bill

Senators Clinton And Frist Promote Health IT Bill

Legislation establishes health IT standards to reduce health-care costs and improve efficiency.

By Marianne Kolbasuk McGee
InformationWeek, June 17, 2005
URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=164900375

Two big-name political rivals set aside their various differences on Thursday to promote an issue both strongly support -- the adoption of health IT. At a press conference at George Washington University Hospital in D.C., U.S. Senate Majority Leader Bill Frist (R-Tenn.) and Sen. Hillary Clinton (D-N.Y.) introduced the Health Technology to Enhance Quality Act of 2005.

The bill -- the fifth introduced in Congress this year promoting the adoption of health IT -- pushes to create an "interoperable health IT system" through the adoption of standards that will help reduce costs, enhance efficiency, and improve overall patient care.

The bipartisan bill also aims to elevate the Office of the National Coordinator for Health Information Technology within the U.S. Department of Health and Human Services, putting it on a par with the Centers for Medicare and Medicaid Services and the Agency for Healthcare Research and Quality.

Under the legislation, federal spending on health IT would be coordinated through the office of national health IT coordinator, which is held by West Virginia native Dr. David Brailer. That position was created last year under an executive order from President Bush, who also last year established a goal for most Americans to have electronic health records by 2014.

Among other provisions, the bill would provide $125 million in grants for regional and local consortiums building interoperable health information exchanges. The bill also calls for a study of state privacy laws to determine how they may impede the exchange of health information within and between states.

Last month in the House of Representatives, Rep. Patrick Kennedy (D-R.I.) and Rep. Tim Murphy (R-Pa.) introduced the 21st Century Health Information Act of 2005 (H.R. 2234), a bipartisan bill also promoting health IT adoption and grants.

Knowledge Economy & Rural America

Here is an interesting item on how rural areas can survive by creating knowledge economies.

Rural America’s Emerging Knowledge Economy

The Federal Reserve Bank of Kansas City published a report recently entitled “Rural America’s Emerging Knowledge Economy.” The report provides strategies on how to build a rural knowledge economy.

Rural leaders have adopted a variety of strategies to build knowledge-based activities in their regions. Among them are:

• Nurturing a high-quality workforce. Rural counties with higher concentrations of high skill labor were found to have higher concentrations of high-knowledge occupations.
• Tapping institutions of higher learning. Rural counties with a college or university had a higher concentration of high knowledge occupations.
• Leveraging scenic amenities. Scenic rural places were found to have higher levels of economic, population, and income growth.
• Building a 21st Century Infrastructure. For example, rural Garrett County in Western Maryland, in cooperation with the county community college, helped supply high speed Internet facilities to an information incubator that will house 20 start-up companies.
• Building regional partnerships. To overcome size and remoteness, partnerships may be the primary key to sustaining rural knowledge-based activity. Partnerships at both the regional and firm level have proven successful in places as varied as Akron, Colorado and Maddock, North Dakota.

Link to PDF: http://www.kansascityfed.org/RuralCenter/mainstreet/MSE_0505.pdf

Other details:

High knowledge occupations account for 20.2 percent of employment in metro areas but only 14.8 percent in rural areas; however, they are growing in rural areas. In 2004, producer service industries--professional and business services, financial and information services--led rural job growth with an annual increase of 4 percent over the previous year, while jobs in consumer services in education, health care and retail trade grew by just 1.6 percent.

Broadband Issues The Same - Rural and Urban Areas

West Virginia, a small, rural state, is struggling with issues related to broadband access and demand. Apparently, this issue is not dissimilar than "connectivity" issues in major metropolitan areas such as New York City. Read below.

New York City broadband study says "Broadband is a public good"
Submitted by andrew on Mon, 06/13/2005 - 1:07pm.
http://www.ruraltelecon.org/dp/

The New York City Committee on Technology in Government has issued an excellent and extensive report (http://webdocs.nyccouncil.info/attachments/66683.htm) on the need for broadband throughout the city. It reaches many of the same conclusions that the City of Seattle reached in its study of broadband. Among the highlights:

• Broadband must be affordable, and the private sector, even in New York City, is not delivering affordable broadband.
• The Committee recommends that the City adopt a goal of universal broadband adoption by every resident, nonprofit, and business in the city.
  The relatively high cost of current broadband offerings prevents many small and medium-sized businesses from being able to leverage savings that might come with broadband (like VoIP).
• The Committee believes broadband is a necessity, not an amenity. The Committee states that "broadband....is a necessity and a public good in today's world."
• The Committee also states that "Broadband is crucial to economic competitiveness." Their rationale is that New York City businesses now compete in a global economy in which businesses located in other countries (with affordable broadband) now compete directly with the businesses located in New York City.
• The report also discusses broadband as a"must have" for businesses and notes that successful recruitment of businesses to locate in the City now depends heavily on the availability of affordable broadband.
• The emerging requirement for bandwidth for an average household is 57-72 megabits/second, with "tech savvy" households using nearly all of a 100 megabit pipe. The report also notes that bandwidth requirements for business are higher than residential needs. The Committee noted that they saw no indication that the cable companies, which hold 75% of the broadband market in the U.S., have any intention of increasing their current single digit (3-5 megabit) capacity.

The report also reviews the work of other cities like Philadelphia and Seattle. There are not many recommendations, but they do recommend that every new building have telecom duct as a requirement, not as an option.

The report is long but readable, and makes a case that local government has a role to play.