Humongous and Moving Very, Very Fast

If I remember the high school physics lingo, speed + size = momentum. Fifteen days ago, Barack Obama became President. Within a week the House had passed a stimulus bill bigger than Shaquille O'Neal in a prom dress. Very soon, the Senate will ink its own version, House and Senate will iron out their differences, and Obama's signature will get the money out of the gate, pronto.There's a generous sprinking of innovation in the $825 billion package, including $20 billion for the development and adoption of electronic medical records keeping. Doctors and hospitals would be eligible for increased medicaid payments if they can demonstrate they are storing patient data electronically.The Philadelphia Inquirer's Josh Goldstein notes that some advocates are concerned there are so many privacy protections written into the bill, the system might have a hard time getting off the ground.There are reasons to tilt pro-privacy. The New York Times reports there's "a small army" of lobbyists pushing to make medical records more accessible. Karen M. Ignagni, a lobbyist for insurers

"criticized, in particular, a proposal that would require health care providers to obtain the consent of patients before disclosing personal health information for treatment, payment or 'health care operations.'Such a requirement, she said, could cripple efforts to manage chronic diseases like diabetes, which often require coordination of care among many specialists."

On the flip side, patient advocates fret that electronic records will provide insurers like the ones Ignagni represents with more excuses to deny coverage.Meanwhile, the nonprofit Center for Democracy and Technology is urging that consent forms be designed with the patient's best interests in mind: more signatures required when marketing is involved, fewer when it's just about treatment:

"Requiring consent for all data sharing in health care will only overwhelm patients, leading them to give blanket consent and providing very weak protection"

The CDT likes the language in H.R. 1.Experts say it's hard to spend money fast and wisely. By this time next year, we may already have a good idea whether medicine's leap to digital is working.Interesting aside: Nexis records the first mention of the term "electronic medical records" from 1993, in Congressional testimony.