Cyber Security Industry Alliance Newsletter •  Volume 2, Number 9 • May 2006

CSIA Congressional Spotlight

Congressman William Lacy Clay (D-MO)

Born: 1956 in St. Louis, MO

Elected: 2000

Committee Assignments: Financial Services, Government Reform (Ranking Democrat, Subcommittee on Federalism and the Census).

Education: University of Maryland, Bachelor of Science degree in government and politics. Also attended Harvard University's John F. Kennedy School of Government and holds Honorary Doctorate of Laws degrees from Lincoln University and Harris-Stowe State University.

Notable: Wm. Lacy Clay was first elected to the U. S. House of Representatives in 2000, succeeding his father, the Honorable Bill Clay, who served for 32 years and was a founding Member of the Congressional Black Caucus. Prior to his election to the U.S. House of Representatives, Mr. Clay served 17 years in both chambers of the Missouri Legislature.

As a member of the Government Reform Committee, Rep. Lacy Clay has been an outspoken advocate for reforming our nation's electoral process; and he serves on the Financial Services Committee where he has worked to promote home ownership and crack down on predatory lending practices.

Congressman Clay, along with Congressman Jon Porter (R-NV), recently introduced H.R. 4832, the Electronic Health Information Technology Act of 2006, designed to strengthen the federal government’s role in developing and strengthening nationwide health information network standards, while allowing private sector stakeholders the flexibility to pursue innovative solutions to serve their needs. He believes that a national health information network is a more efficient and secure alternative to paper based recordkeeping. In addition, a paperless system will reduce the overall cost of healthcare delivery.

Rep. Clay has also been active in Congressional oversight of cyber security, identity theft issues, critical infrastructure protection, and FISMA, promoting ideas to link government procurement to agency information security needs. He worked closely with then-Chairman Adam Putnam (FL-12) of the Government Reform Technology Subcommittee in the 108th Congress on the Corporate Information Security Working Group.



Since the release of the Institute of Medicine’s (IOM) 1999 report, To Err is Human, Congress has sought an appropriate remedy for reducing the extensive rate of medical errors in our health care system among economically and geographically disparate patient populations. The task is formidable, as medical errors account for between 44,000 and 98,000 deaths annually, along with countless other injuries having adverse impacts on the lives of those affected. It should be noted that we have made some progress, as legislation promoting the use of electronic prescriptions in Medicare and the establishment of medical error reporting systems has been enacted. Having taken these steps, however, I believe the time is now for us to pursue a nationwide electronic health information infrastructure that will significantly transform our health care system into a model of medical efficiency and quality.

Our nation remains at risk on many fronts, including long-term crises such as HIV/AIDS, the emergence of antibiotic resistant strains of viruses, flu epidemics, bioterrorism, and natural disasters, all of which have significant public health consequences. These problems are compounded by demographic disparities in access to quality health care, an increasing population of uninsured citizens, and costs for services that continue to outpace the annual rate of inflation.

In 2003, the IOM estimated our total national expenditures on health care to be approximately $1.7 trillion of our economy. Much of this is driven by government efforts to make the provision of health care a public good for all to benefit from. Through programs such as Medicare and Medicaid, we have sought to provide equality among all individuals needing health care regardless of socioeconomic need or circumstances. From this perspective, I believe it is time for the federal government to lead in the development and adaptation of a nationwide health information network that can further diminish such barriers and improve upon the quality of care provided to all of our citizens.

The widespread adoption of health information technology (IT) will provide a platform for delivering higher quality care more efficiently and economically than current paper-record based information systems. A recent study undertaken by the RAND Corporation estimated that the implementation of a nationwide health care information network that is utilized by 90% of providers would produce an annual savings of approximately $80 billion. More importantly, the number of inpatient adverse drug reactions would be reduced by roughly 200,000 incidents annually, and by over 2 million incidents in outpatient settings. These statistics are difficult to ignore as we seek better outcomes from a current system that is error prone, economically inefficient, and incompatible with the information age.

The cost of developing a nationwide interoperable system cannot be ignored, however, as RAND estimates these costs to exceed $100 billion over a 15-year implementation window. Furthermore, there are few guidelines or agreed upon standards to ensure these private systems are interoperable for providers and institutions of all sizes. Therefore, I believe it is imperative that the federal government lead in the establishment of a blueprint for interoperable data, coding, and transaction standards for all federal agency health care systems, while providing additional financing options for the development and implementation of electronic health record systems among private sector health care providers.

In response to these challenges, I, along with Congressman Jon Porter (R-NV), recently introduced H.R. 4832, the Electronic Health Information Technology Act of 2006. The primary purpose of this legislation is to strengthen the federal government’s role in developing and strengthening nationwide health information network standards, while allowing private sector stakeholders to remain innovative in their own health IT implementation efforts. This legislation, while incorporating many different ideas and policy proposals from colleagues and industry, seeks to accomplish two major endeavors.

First, the legislation would codify the current Office of the National Coordinator for Health Information Technology and strengthen its role as the leading health information standard setting organization in the federal government. The office will be led by a presidential appointed and Senate confirmed Chief Health Informatics Officer, and will have authority over all health IT standard setting activities for the federal government. The new CHIO will have the capacity to partner with the private sector through expanded grant and demonstration programs, providing both economic resources for research endeavors and implementation costs among institutions seeking to expand their electronic health information capabilities.

Second, the legislation will establish a loan program, modeled after the William D. Ford Direct Loan Program for students, to provide financing options to providers and organizations in the process of establishing electronic health record and information systems. A major barrier to developing a nationwide health information network is the capital costs involved with the design and implementation of systems, particularly among small providers lacking access to capital markets or specialized financial instruments. Thus, I believe the federal government ought to leverage its economic resources in a responsible manner in order to provide such capital where necessary, and the Direct Loan program provides a model to do so.

Once achieved, we will have a national electronic health architecture that is technologically feasible, yet ready to incorporate new IT advances in the future. Furthermore, by consolidating the authority for developing appropriate health IT architecture requirements into one office, we will reduce duplicative standards development efforts among federal agencies and provide the marketplace with a model for efficient and secure health information exchange.

If we continue our pursuit of utilizing IT throughout our health care delivery system, we are sure to experience shorter hospital stays, improved management of chronic disease, and a reduction in the number of needless tests and examinations administered over time. While it is not a panacea, I believe the pursuit of such a network will prove far more efficient in both economic and human terms than its costs, and will become a foundation for employing cutting edge health care technology for the betterment of society.