Opinion

BE LIKE IKE AS A HEALER

PRESIDENT-ELECT Obama has shown that he is not afraid to tackle the nation’s toughest problems head on. One of the most pressing and intractable is to drag America’s health system out of the Stone Age and into the 21st century through information technology.

The president-elect should be applauded for making this vital priority a key part of his economic stimulus plan, but more importantly, as the starting point of his health reform agenda. Last week he pledged, “We will make the immediate investments necessary to ensure that within five years, all of America’s medical records are computerized.”

Now comes the hard part: succeeding.

The president-elect should look to his predecessors for guidance, as he is not the first to take on such a massive challenge. He should look no further than President Dwight D. Eisenhower.

Eisenhower faced virtually the same problem in the mid-20th century when he envisioned a nationwide interstate highway system. That creation, which now bears his name, remains one of the most important and significant accomplishments in American history. While such a system had long been a dream, it was Eisenhower who made it a reality when he proposed and then signed the Federal Aid Highway Act, beginning the construction of more than 41,000 miles of interstate highways.

Eisenhower’s leadership created a wave of productivity and prosperity that we continue to ride today. It opened new markets, created a national sense of community, brought the modern world to rural America, enabled families to move and vacation over long distances and drove innovation from coast to coast. The total sum of benefits, both economic and social, is enormous.

Prior to the highway system, Eisenhower described the nation’s roads as “an appalling problem of waste, danger and death.” This is an apt description of our health-care system today.

Using manual, paper-based processes that are more akin to Eisenhower’s era than today’s modern world, health care is the largest and most antiquated part of our economy.

A scant 4 percent of physicians use advanced electronic medical records, despite irrefutable evidence and experience that information technology saves lives and saves money.

We can change this if we apply four critical lessons from Eisenhower.

* First, make a significant financial commitment. In 1956, Congress appropriated $25 billion for highway construction, which was a vast sum of money, considering that total federal spending in 1956 was $70 billion. Hundreds of billions of dollars were eventually spent, making it one of the nation’s highest priorities.

Obama has proposed spending $50 billion over five years on getting information technology into the hands of doctors and providers. It will take many years to build a nationwide system, but this commitment is more than any other policymaker has pledged. Congress is working to include a down-payment on that promise in the current economic stimulus package.

* Second, ensure that we create an interconnected system. One of the most important components of the highway system was its adherence to uniform standards of construction. This avoided each state building their own highways with their own unique specifications.

Health care runs a similar risk. If billions are spent to equip doctors and hospitals with technology that cannot communicate with each other, we will have laid a lot of track that doesn’t connect. Existing efforts to finalize technology standards should be strengthened, and this should be coupled with a requirement that any system purchased with federal dollars must be certified and adhere to these standards.

* Third, create a true collaboration between the private sector, states and the federal government. Even though the federal government paid 90 percent of the costs of building the highway system, the states were responsible for managing the construction and the private sector did the actual work.

A similar approach would work in health IT. Many states are already working with technology companies to connect their health-care communities. Presidential leadership and federal dollars would speed the process.

* Lastly, guarantee long-term funding streams. The interstate highway system was funded by the Highway Trust Fund, providing steady, long-term funding.

Obama’s $50 billion pledge for health IT should be viewed as a transformational down payment. Long-term financing must come by fundamentally changing the way we pay for health-care services. Incentivizing the use of technology, an approach that the Congress used last year by providing financial incentives to doctors who use electronic prescribing tools rather than a prescription pad, should ultimately give way to paying for better quality care, not just a larger quantity of services.

Moving health care into the 21st century is the first step to transforming the system; one that provides every single American more choices of greater quality at lower cost. President Eisenhower showed us a model of success. President-elect Obama can apply these lessons from the past, so we can build this brighter future.

Former Speaker of the House Newt Gingrich is founder of the Center for Health Transformation.