Sen. Sheldon Whitehouse (D-R.I.) told a HIMSS09 Town Hall audience on Sunday that healthcare IT is reaching a crisis stage.

"The days of Harry and Louise are over," Whitehouse said to a packed house. "We are now in the era of Thelma and Louise and the cliff is coming up fast."

"If we don't get this right, we're in real trouble," he added. "Health IT will be the backbone."

Whitehouse said Traditional solutions, such as raising taxes or limiting coverage, will be "totally unsuccessful" in preventing the "tsunami of healthcare costs (that) are coming at us." He instead promoted a delivery system overhaul that would include healthcare IT infrastructure, quality improvement, wellness and prevention programs and payment alignment to desired healthcare outcomes.

Whitehouse said the Obama administration gave the IT portion of health reform a needed push with its "leap of faith" in investing $20 billion in health IT in the stimulus package.

He dismissed skeptics' defense of CBO actuarial studies of health IT investment. CBO uses the past to predict the future, he said, and health IT is so new that future benefits are difficult to predict.

Whitehouse said he recognizes the urgency providers and vendors have for defining "meaningful use" of healthcare IT to qualify for Medicare payment bonuses. As mandated by the stimulus package, the Health and Human Services Secretary (likely to be Kansas Gov. Kathleen Sebelius) will be able to make that definition. 

Whitehouse said coming up with a definition will be "difficult and complicated." He speculated that HHS may choose to focus on one element, such as a particular disease, location or model, to demonstrate meaningful use.

"We need to see what lowering costs would really look like," he said.