January 12, 2004 Senator Clinton Offers Proposal to Improve Health Care for All Americans New York, NY - Signaling her ongoing commitment to improve health quality for all Americans and lower health costs, Senator Hillary Rodham Clinton unveiled a significant proposal designed to use the advances in technology to improve our health care system. By better using information, Senator Clinton believes we can streamline and modernize the nation's healthcare delivery system to improve quality and affordability. In a speech delivered at the Cornell Medical Center in New York, the Senator discussed her legislation. "We have the most advanced medical system in human history - the finest medical institutions, the newest treatments, the best trained health care professionals. But, in spite of the best intentions of clinicians and patients, our health care system is plagued with underuse, overuse and misuse stemming from the complexity, duplication and bureaucracy of our health care delivery system," Senator Clinton said. The problems are varied and significant. Only half of the care that is known to be effective is provided, and the care that is provided varies widely from one encounter to the next. Only 20% of the care we give is supported by scientific evidence and when research leads to the discovery of effective new treatments it can take up to 17 years before those treatments become commonplace. Meanwhile, paperwork can consume more than a half hour for every hour of patient care. In addition to shortchanging patients on care, these problems artificially increase the cost of care. Just last week, the Department of Health and Human Services reported that healthcare costs now represent a full 15% of the nation's Gross Domestic Product and the number is expected to keep rising. The legislation Senator Clinton outlined in her speech, today, envisions a health care system modernized through the use of information technology to provide key health care decision makers-providers, payers, and patients information where and when it is needed. "In the 1990s, many industries transformed through the use of information technology. Health care has not done so but can and should," said the Senator. "Information, in the hands of the right people, at the right time, drives quality and value." Senator Clinton's legislation puts forth a five-point plan to achieve this goal: 1) Increase research on quality of care. Approximately 80% of the care delivered today is not backed by clinical research, and instead represents health professionals doing their best in the absence of solid data. Senator Clinton's plan would assure that we fund research to reduce this knowledge gap, that we research the effectiveness of care delivery systems in addition to the effectiveness of individual procedures, and that we do more comparative, or head-to-head trials of drugs and other therapies, so patients know which drugs are the most effective, not just most advertised. 2) Provide the public with a standardized reporting system that allows consumers to reliably compare performance. Some states, including New York, have started to issue hospital and other report cards. But the lack of standard performance measures and lack of readily available data means the public, even if they have access to one of the newer state report cards, can rarely compare the quality of health facilities across the country. Senator Clinton's bill supports standardized measures that allow for quality comparisons. It also calls for a move to electronic health records, which will make data available at lower cost than paper reporting. 3) Build an information technology infrastructure that enables information sharing. American health providers lag behind other countries in adopting electronic health records because of barriers including lack of funding, fear of wasting money on systems that won't "talk" to other systems, and fear of regulation. Senator Clinton's plan addresses these concerns through steps including the establishment of voluntary "interoperability standards" to ensure that different hospital and physician systems can talk to each other, exchange electronic health records, and reduce paperwork. 4) Give patients and providers information in real time. Senator Clinton not only supports health information technology (IT) infrastructure, but health information technology developed in a way that provides information in real time to patients, providers, and purchasers so they can make decisions more effectively. This includes giving providers the latest research, clinical guidelines, reminders, and information, right at their fingertips through hand-held computers and other tools, and giving patients access to their health record as well as personal health tools to involve them more in their own health care. 5) Pay for performance. The current Medicare payment structure can sometimes penalize quality. Senator Clinton's legislation funds further studies and demonstrations to identify promising payment structures that incentivize and reward performance.