The CBO report explained that healthcare IT refers to computer applications in the practice of medicine that include computerized entry systems for physicians ordering tests or medications; systems that provide help in decision-making about treatment options; and electronic prescriptions. Healthcare IT can involve housing all of a patient’s medical records in an electronic medical record (EMR) or offer greater networking with other systems through an electronic health record (HER) IT package.

 

The CBO report made these points:

 

- EHRs can help physicians deliver healthcare more efficiently by enabling them to enter notes into a computer instead of paper file, eliminate the need to physically pull out records of previous patient visits, encourage greater use of generic prescriptions, and reduce duplication of diagnostic tests

 

- EHRs can help improve the quality of healthcare by providing physicians’ reminders of important preventive care measures, identifying harmful drug interactions, and aiding in the healthcare management of patients with chronic conditions

 

- The benefits of healthcare IT and EHRs are easiest to document for integrated healthcare delivery systems, but have not been shown for providers and hospitals that are not part of an integrated system (in some cases, IT could increase costs for these providers and hospitals, not reduce them)

 

- Providers and hospitals that benefit financially will be more motivated to adopt EHRs. If these systems provide internal benefits for them, implementation can be expected to proceed quickly; if the cost benefits are primarily external, implementation will be slow (as seen in the 11 to 12 percent figures cited in the Wall Street Journal article)

 

- If the government chooses to take a role in encouraging greater use of healthcare IT, the more sound approach budgetarily would be through a penalty on providers and hospitals who fail to implement IT, instead of through costly subsidies – in other words, the stick instead of the carrot.

 

-- A promising “widespread” application of healthcare IT lies in using it to collect data for empirical studies on the cost-effectiveness of specific treatments

 

Inasmuch as the CBO’s dismissal of two prior studies that concluded widespread implementation of healthcare IT might lead to savings of about $80 billion a year, the CBO gave three specific reasons for its views. (The points here relate to the RAND study more than the study by the Center for Information Technology Leadership.)

 

1)      The study used a broad standard, measuring potential, rather than likely, impact of healthcare IT implementation

 

2)      The study was based solely on studies from literature than found positive effects for implementing healthcare IT systems and excluded studies – even those in peer-reviewed journals – that failed to find favorable results for healthcare IT

 

3)      The study assessed savings based on policies in effect in 2004 and did not account for growth in implementation of healthcare IT (from then to now) that has occurred without any changes in policy, as the CBO does in preparing its official cost estimates

 

The Pew Research Center in February presented the latest forecast (“Immigration to Play Lead Role in Future U.S. Growth”) on population growth and immigration trends, forecasting that 82 percent of the projected growth in population from 2005 to 2050 will be immigrants and their U.S.-born children.

By 2050, nearly 1 in 5 Americans will be an immigrant, compared to 1 in 8 today, the Pew Research Center said. Hispanics will be the fastest growing component of immigration growth with this group tripling in size, growing from 3.5 percent of the population in 1960 to 14 percent in 2005 and 29 percent in 2050, according to the report. 

The Pew Center ’s projections are based on assumptions about recent birth, death, and immigration levels, which can change. Alternative scenarios, based on lower and higher immigration levels, also were presented. 

U.S. Food and Drug Administration’s Center for Drug Evaluation and Research web site.

This 2002 study by the Federal Trade Commission is a 129-page report examining a myriad of issues involved with prescription drugs – brand and generic – including costs, research and innovation, and antitrust considerations.