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Rushing HIT legislation could increase healthcare costs

While Drug Store News has been, and continues to be, a staunch supporter for the widespread adoption of healthcare information technology — as it is the most logical first step toward a working healthcare system where providers communicate, patients get better, and payers get their money’s worth — rushing HIT legislation through in the name of economic stimulus is the wrong idea. And, not because HIT adoption won’t create jobs and stimulate the economy, either.

Building the infrastructure, making sure that all systems can talk to each other and then maintaining those systems will no doubt require countless manpower hours, and create tens, and maybe even hundreds of thousands of new jobs in health care. That’s a good thing. But all the extra privacy provisions that have been tacked on to the House bill would not only add exorbitant and unnecessary cost to implement — and particularly to pharmacy operators, who by and large, have already invested considerably in healthcare technology systems in contrast to other provider groups — but it has the potential to set patient care back considerably in this country.

For instance, the “accounting of disclosures” provision being considered would mean that every time a pharmacy submitted a claim for reimbursement — which, of course, requires the disclosure of the health information of the patient in question, between the pharmacy and the insurance company — it would have to keep a record of that action for at least three years. Forgetting the cost to store that kind of transaction data, which would number in the billions, most if not all pharmacies would have to junk their existing pharmacy systems and buy entirely new ones, as the original systems were not designed to that requirement.

In addition, under the proposed “marketing issues” provision, pharmacies would be required to get a specific patient authorization form, for each specific case in which the patient’s health information might be used to generate a communication to that patient. No single patient authorization can be used for more than one purpose; each must have a specific expiration date, and patients can decide to revoke their authorization at any time.

So, basically, if a pharmacy wants to send a patient a refill reminder, they will need the patient’s prior authorization; if that same pharmacy wanted to send that same patient information about a disease state management program that could help manage the condition for which the prescription was written in the first place, that requires a separate authorization. Want to tell them about a flu shot? That’s another patient authorization. Last year non-compliance cost $177 billion in unnecessary healthcare costs; how does this help reduce those costs? Moreover, how does this provision help prevent the negative health outcomes that drove those costs?

Simply, it doesn’t.

And that’s not all, but it’s at least two good reasons why Drug Store News believes healthcare IT should not be part of the current stimulus bill. It’s bad for pharmacy, and it’s even worse for patients in the long run. The only thing it will stimulate is a lot of unnecessary cost in the name of patient privacy.

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