One of the goals of the bill, passed by a voice vote of the House Energy and Commerce Committee, is for every American to have an electronic health record by 2014. Supporters say that greater use of such technology will sharply reduce medical costs while improving the quality of care.

Unanimous approval by the House committee represents a significant achievement for a bill that has had to overcome much resistance. Patient advocates and interest groups have raised fears about privacy violations related to the electronic sharing of medical information.

Under the bill, an individual would have to be notified whenever their health information is compromised. Other provisions prohibit the sale of protected health information and give patients greater control over the use of their records.

A smiling Rep. John Dingell, chairman of the House Energy and Commerce Committee, was happy to see the bill sail through the committee after years of work on the issue.

“We have squeezed all the controversy out of it,” he told reporters after the panel vote. But the bill has not overcome all the obstacles in its path to the House floor.

The House Ways & Means Committee also has jurisdiction over the privacy provisions of the bill and could offer its own legislation. A subcommittee is scheduled to hold a hearing on health information technology Thursday, July 24.

Beyond potential Ways & Means action, further negotiations remain on the House commerce bill. During the Wednesday, July 23, markup, several members of the committee expressed continuing concerns about privacy—from those who thought the bill didn’t go far enough and from members who worried that restrictive legislative language would discourage providers from implementing medical information technology.

Dingell assured his colleagues that he would work with them as the legislation moves on. The bill represents “a delicate balance between promoting and encouraging the electronic flow of health information and protecting that information from those who should not have it,” he said.

Now the bill must compete for time on a quickly dwindling congressional calendar. After a House vote occurs, negotiations with the Senate loom.

Both the Senate and House versions would make permanent the Office of the National Coordinator of Health Information Technology within the Department of Health and Human Services.

Originally created by a presidential executive order, the office would guide the development and adoption of health IT. In the Senate bill, a public-private partnership would make recommendations to HHS on interoperability and voluntary standards. The House bill would establish federal advisory committees.

The House and Senate bills also provide incentives for doctors and hospitals to buy health information technology. The House funding is $560 million, which is targeted mostly at small and rural providers. The House’s privacy protections are stronger than the Senate’s.

As is the case with all compromise legislation, no one is happy with every aspect of the bill. But Republicans and Democrats both urged their colleagues not seek major changes.

“We shouldn’t let the pursuit of the perfect be the enemy of the good,” said Rep. Joe Barton, R-Texas and the highest-ranking Republican on the House commerce committee. “I truly believe that it will change the way health care is practiced in America for decades to come.”

A leading Democrat on the committee stressed that tinkering with the bill could be fatal at this stage of the process.

“One step in another direction could cause us to fall off course,” said Rep. Frank Pallone, D-New Jersey.

Health care technology advocates are urging Congress to get the bill done this year.

“America can’t afford coverage for all, if we don’t have health IT,” former Rep. Nancy Johnson, R-Connecticut and co-chair of the Health IT Now Coalition, said last month. “We must push the ball over the line this session or we will pay dearly.”