HIT in the American Economic Recovery and Reinvestment Plan

Recently John Halamka outlined the potential impacts of several legislative acts that will change the face of national health care standards and information access. The House Ways and Means Committee completed a bill as part of the American Economic Recovery and Reinvestment Plan. Additionally, a bill completed by the House Appropriations Committee outlines several additional programs of the Ways and Means Committee bill.

Here some highlights of both of these bills:

-Outline of the Office of the National Coordinator (ONC). This position's ultimate responsibility, appointed by the head of the HHS, is to oversee and approve guidelines in the development of a national health information technology infrastructure. The conditions of this infrastructure is that patient's health information is "secure and protected", "improves health care quality", "reduces medical errors", "reduces health care costs", "improves the coordination of care among hospitals", and to satisfy the capitalist perspective, "promotes a more effective marketplace, greater competition, greater systems analysis, increased consumer choice and improved outcomes in health care services".

-Establishes the HIT Policy Committee and HIT Standards Committee with the ONC as chair.

-Notes that the National Coordinator in consultation with the Secretary of the HHS can opt out of the national health IT infrastructure if the needs are satisfied by the free market. Look for follow up on this topic.

-Establishes centers to conduct health care information technology research, overseen by the National Institute of Standards and Technology and the National Science Foundation. It will be interesting to see the means of data acquisition from the marketplace for this research.

-It outlines $20 billion in incentives to support HIT through Medicare and Medicaid funding and reimbersement. Medicare reimbursement incentives to eligible professionals and hospitals that demonstrate a level of use of a certified EHR product. It outlines Medicaid reimbursement incentives to eligible Medicaid providers that demonstrate a level of use of a certified EHR, as determined by CCHIT.

Halamka accutely identifies the needs to break down this implementation of the infrastructure to the state level, noting interoperability and implementation standards to be the key obstacles to success. Hopefully the implementation standards and policy makers recognize and push for project team funding in partnership with each state's medical association HIT branch.

So who will be the first National Coordinator?