Newt's vision.

• Author: Mertz, Kory
• Position: Newt Gingrich - Interview

Former Speaker of the U.S. House of Representatives Newt Gingrich is a frequent commenter on health IT issues. He is founder of the Center for Health Transformation, which seeks to create system wide transformation of health care. Gingrich will be speaking at NCSL's 2008 Legislative Summit on July 24 in New Orleans.

Q. The U.S. health care sector is one of the last to be transformed by information technology. Why do you think this is?

A. There are many obstacles blocking progress, from the vast decentralization of the industry to payment models. Two of the biggest obstacles are governmental regulations and a lack of interoperability standards for data exchange.

Take Stark and Anti-Kickback laws. They were designed to protect patients and health systems from criminal providers and suppliers by prohibiting physicians from referring their patients to healthcare centers with which they have a "financial relationship." That's certainly necessary, but they have the unintended consequences of preventing hospitals and health systems from sharing with physicians their health information technology systems, particularly electronic health records. Granted, there has been movement on this front with HHS (Health and Human Services) opening some exemptions for IT, but they did not go far enough.

Another obstacle to overcome is the lack of interoperability standards for data exchange. Although more physicians' offices and hospitals have modernized their own healthcare delivery systems, they have built customized silos with individual data standards that are virtually unrecognizable to outside systems.

Q. What will have to happen before health IT is widely adopted?

A. Before the United States can modernize its care delivery process through HIT, we must start with rooting out waste and inefficiencies by fundamentally changing the way we pay for the delivery of care. We need to move from a transaction-based model to a quality--or outcomes--based model. This will not only eliminate the financial incentive to use tests, treatments or therapies that are not directly beneficial to the patient or the care process, but it will have second-order effects of driving the adoption of tools and techniques that will produce better outcomes, such as electronic health records, electronic prescribing, and adherence to clinical guidelines/best practices.

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Q. What role do you see for government in advancing health IT? What sorts of things should...