On June 29, 1956, fifty years ago today, President Eisenhower signed the Federal-Aid Highway Act. It called for the construction of more than 40,000 miles of interstate highways and appropriated $25 billion over ten years. This was a vast sum of money, considering that total federal spending in 1956 was $70 billion, making it one of the nation’s highest priorities.
President Eisenhower forced the country to act: "The obsolescence of the nation’s highways presents an appalling problem of waste, danger, and death." The President, the Congress, and the states knew that a national, interconnected highway system would be a vital tool to prepare for and respond to a national emergency. Many envisioned their use as runways for military aircraft in case of a national emergency, so it was no mistake that the original name of Eisenhower’s vision was the National System of Interstate and Defense Highways. As he put it, an interconnected system "is as necessary to defense as it is to our national economy and personal safety."
Fifty years later, another national, interconnected system is needed. Our generation must build a national health information system because it, too, is vital to our national security. Just like Eisenhower’s highways, a health information network will eliminate the "waste, danger, and death" of the current health system.
A modernized, interconnected healthcare system would electronically link physician offices, hospitals, pharmacies, public health agencies, and other key first responders, providing valuable data to prepare for and respond to an emergency.
In an extreme disaster, such as Hurricane Katrina, an avian flu pandemic, or a terrorist attack using a weapon of mass destruction, advanced expert systems could perform a variety of essential services: electronically tracking patient hospital visits, their symptoms, and their conditions; directing scarce resources to where they are most needed; assessing the effectiveness of response strategies in close to real time; supporting contact tracing for appropriate infectious diseases; determining possible origins and causes of an outbreak; and capturing other vital sources of data.
The earlier we can detect a public health crisis, the better the chance we have of containing and managing it. But electronic information–nationwide, wherever it is needed–is the key. Without it we are no better off than in the days before Eisenhower’s highway system.
A national health information network would also help us in the aftermath of an extreme disaster. More than one million paper medical records were destroyed in Katrina’s fury and the subsequent floods. Nearly all citizens fled the Gulf with no medical histories, no medication lists, no treatment regimen, no lab results–no healthcare documentation of any kind.
M.D. Anderson in Houston, one of the premier cancer centers in the world, treated hundreds of evacuees in the aftermath of Hurricane Katrina. For those Gulf residents who were in clinical trials with the National Cancer Institute, their data was electronic and available immediately at M.D. Anderson, and their treatments were resumed exactly where they left off. For those who did not have electronic records, doctors scrambled to redo tests and recreate intricate treatment regiments.
Intuitively we know that many people died as a result. Their cancer killed them–but the lack of information most assuredly did as well.
The Department of Veterans Affairs also demonstrated the power of health IT after Hurricane Katrina. Because of the VA’s long investment in health IT, when veterans from the Gulf arrived at VA facilities across the country, their full medical histories were intact and available immediately.
President Eisenhower’s leadership changed the face of America forever. His vision of a national highway system created a wave of prosperity that we continue to ride today. It opened new markets through interstate commerce, created a national sense of community, brought the modern world to rural America, and drove innovation from coast to coast. The benefits, both economically and socially, are incalculable.
A national health information system would have the same effect. When there is no emergency to respond to, it would be the information highway that every doctor and healthcare provider in the country could use in the course of care. From electronic prescribing and remote patient monitoring to clinical trial applications and medical research, a national health information system could be the highway that allows for the connectivity, efficiency, and improvement that we all aspire to achieve in healthcare.
Unfortunately, the Congress has played games with health IT legislation for more than a year. It is time for action. This Congress should see the dire necessity and stunning potential of building a national, interconnected system that will save lives and save money–in war-time and in peace. Our predecessors knew it fifty years ago. What is our excuse?
Newt Gingrich is the former Speaker of the U.S. House of Representatives and Founder of the Center for Health Transformation. David Merritt is a Project Director at the Center. For more information, visit www.healthtransformation.net.