Newt Gingrich and Patrick Kennedy agree that building computerized health-information networks will save lives and save money.

09:40 AM EDT on Tuesday, June 22, 2004

BY FELICE J. FREYER
Journal Medical Writer

Journal photo / Bob Breidenbach Rep. Patrick Kennedy, former House Speaker Newt Gingrich and Edward M. Kennedy Jr. chat on the Brown University campus yesterday where they took part in a conference that dealt with modernizing the health-care system.

PROVIDENCE -- The pair provided an occasion for lots of gentle jokes: conservative icon Newt Gingrich, the former Republican House speaker, teaming up with Rhode Island's congressman from the famous liberal family, Patrick Kennedy, to promote information technology in health care.

Kennedy elicited laughs from a luncheon crowd yesterday when he described the stares he and Gingrich attracted when they walked together in Washington, while Gingrich said he didn't envy Kennedy explaining yesterday's event to House Minority Leader Nancy Pelosi.

But it quickly became clear at the Brown University conference -- sponsored by Kennedy, with Gingrich as keynote speaker -- that there's nothing remotely partisan or ideological in their proposal to wire the health-care system.

And also, that it's no joke.

"People die every day we don't move to a 21st-century, intelligent health system," Gingrich told some 400 people from health care, academia and government attending the "2004 Frontiers of Health Care Conference: Transforming Health Care Delivery for the 21st Century."

People die from medical errors -- up to 98,000 a year, according to an oft-quoted study from the '90s. And most of those errors could be prevented by computer programs that flag mistakes and improve communication; for example, bar codes keep the nurse from accidentally grabbing the wrong medication, or electronic prescribing spares the pharmacist from having to decipher the doctor's handwriting.

"The fact is that paper kills," Gingrich said.

What makes it all a nonpartisan no-brainer is that improved information technology not only saves lives, it saves money -- sometimes, Gingrich said, providing a return on investment within months.

Backed by Gingrich's Center for Health Transformation, Kennedy plans to file legislation that would begin the process of building health-information networks, promote research into what works and what doesn't in health care, and set up payment systems that will reward high-quality care.

How much will it cost? Does the Republican Gingrich really want to raise taxes to pay for this? Kennedy has put a low $5-billion price tag on his bill. Gingrich, the Republican, admitted: "I'd actually like to spend more."

Gingrich thinks the federal government should pay the cost of creating Web-based individual health records that every patient can access. The record will detail the care the patient has received from each of his doctors, so his care is better coordinated among them.

The place to start with this program, Gingrich said, is Medicare, the federal health program for the elderly. In January, for the first time, people new to the Medicare rolls will get a "welcome to Medicare" physical. That is the time to create the computerized medical record for each new Medicare patient, Gingrich said.

"We are just nuts if we start in January with paper records," he said. Each computer record will cost $10 to create and $3 a year to sustain.

But the federal government, as the world's largest health-care purchaser, can promote patient safety and technology in ways that don't cost taxpayers a penny, Gingrich said. For example, if the federal government bought only single-dose, bar-coded medications, they would quickly become the norm in the private sector.

An "off-budget government loan program" could finance information systems at hospitals, Gingrich said. And the government could change the way it pays for health care to reward people who invest in technology.

For example, George Vecchione, president and chief executive officer of the Lifespan hospital system, said in an interview yesterday that Lifespan had seen a reduction in medical errors -- but no direct financial rewards -- from its new system in which doctors maintain patient records and order tests and drugs by computer. When medical errors are prevented, the insurer or government agency that would have paid for the patient's resulting illness reaps the benefits.

And if, as one study suggested, one-quarter of emergency-room visits result from medication errors, then emergency rooms lose one-quarter of their business when the errors stop. "Many of the improvements in health bankrupt the people invovlved in it," Gingrich said. Instead, the federal government should pay for quality, not quantity.

Gingrich also touted the idea of selling medications online in the same way as airline tickets. "They could give you daily pricing for every drug every day," and competition would drive drug prices lower than those in Canada, he said.

Rhode Island, Gingrich said, "could really be a model for the country," because its small size allows for experimentation, and because of the work of the Rhode Island Quality Institute.

The institute, a nonprofit group of health leaders set up by former Attorney General Sheldon Whitehouse, has already introduced a system in which doctors' prescriptions are transmitted directly to pharmacies. So far 70 percent of the pharmacies in the state, and 250 doctors, are connected to the system -- with an additional 600 doctors scheduled to link up in the fall.

Gingrich surprised his audience by saying he'd like to see the savings from information technology go toward ensuring that every American has access to health insurance.