Jay Rollins offers a recap of the last day of this year’s Healthcare Information and Management Systems Society (HIMSS) conference. Find out why he thinks Alan Greenspan’s comments lead to more questions than answers.


Alan Greenspan, former Chairman of the Federal Reserve, kicked off the final day of the Healthcare Information and Management Systems Society (HIMSS) conference in Chicago, IL. He focused on why the economy is in the state it is in and highlighted some of the telltale signs that we may be heading out of it; for instance, the dramatic decline in inventories has begun to slow. But I felt his remarks lead to more questions than answers; the questions raised focused more on how the economy will impact health care.

Greenspan reflected on conversations he had with a colleague regarding the relationship between health care and the economy. Their conversational analysis pointed to the fact that the cost of health care did not directly influence the economy or the current economic situation. The growth of the economy over the past several decades had grown sufficiently enough to bear the accelerated costs of health care. This raised the question: Will the depletion of real wealth in the United States and the depth of the current recession put an end to that trend?

Greenspan noted that he expects to see a 1% reduction in the growth rate each year for the next four to five years. “Medicare cannot continue to grow at 2% annually forever,” he said. The combination of a lower growth rate and annual Medicare increases is just not sustainable. During his time in government service, he was asked to tackle the question of Medicare, which he admittedly avoided primarily because of politics and the fact that the Baby Boomers were not going to have an economic impact until the early 21st century, a prediction he made 20 years ago.

Eventually this will need to stop, but it seems to have been left up to the market to say when consumers will have to start cutting back. And that is a state of affairs that will force health care to get systematic about the approach to health care in the United States. If the consumer is forced to cut back because of fewer federal subsidies in Medicare, this country could be in for a health care crisis, which could lead to consumers avoiding routine physicals or dealing with illness at home instead of in the hospitals.

The buzz after Greenspan spoke reinforced the sense of urgency regarding electronic medical records (EMRs) and a more systematic and scientific approach to health care in the United States as articulated by George C. Halvorson, Chairman and CEO of Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Hospitals, earlier in the week.

Encouraging demonstrations of the Nationwide Health Information Network (NHIN) at the HIMSS Interoperability pavilion showed the future of health exchanges and other new technologies that will facilitate the accelerated adoption of EMR.

And despite cutbacks in technology in other sectors of the economy, there is a mini boom in health care IT. The promise of early adoption bonuses has had the desired affect. The 20th Annual HIMSS Leadership survey found that the bulk of the money being spent is in clinical systems, particularly with EMR and computerized provider order entry systems (CPOE). The survey also pointed to IT staff growth, which has slowed, but it is still growing. Additionally, information security is still a top concern.

Could it be a bubble? Possibly. It all depends on what happens with Medicare and the growth of reimbursements. The bottom line is that there is a sense of urgency in the health care industry. There is stimulus money available now to invest. This will not go away or be fixed overnight. The challenges are ensuring vendors are part of the solution rather than part of the problem and making sure that pork stays out of the mix.

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