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HITECH Act to Tear Down e-Health Barriers

Many of our readers were in the listening audience yesterday for the MLA webcast, “Cut the Cord: Connecting to Our Mobile Users.”  In the webcast, I discussed some funding opportunities, including those in the American Recovery and Reinvestment Act (ARRA) of 2009.  A part of ARRA, is the Health Information Technology for Economic and Clinical Health (HITECH) Act.

The HITECH bill accomplishes four major goals that advance the use of health information technology (Health IT), such as electronic health records by:

  • Requiring the government to take a leadership role to develop standards by 2010 that allow for the nationwide electronic exchange and use of health information to improve quality and coordination of care.
  • Investing $20 billion in health information technology infrastructure and Medicare and Medicaid incentives to encourage doctors and hospitals to use HIT (Health Information Technology)  to electronically exchange patients’ health information.
  • Saving the government $10 billion, and generating additional savings throughout the health sector, through improvements in quality of care and care coordination, and reductions in medical errors and duplicative care.
  • Strengthening Federal privacy and security law to protect identifiable health information from misuse as
    the health care sector increases use of Health IT.

(This information comes from the Committee on Ways and Means – http://waysandmeans.house.gov/media/pdf/110/hit2.pdf)

It is obviously important to everyone involved, to keep the information kept in electronic health records secure.    Along with federal laws being strengthened, this bill requires that a notification be sent to the owner of the EHR in case of a breach or some other unauthorized disclosure of their record.  It also allows patients to have full transparency – this will allow the patient to request an audit trail showing and and all requests of their EHR.

Dr. David Blumenthal, national coordinator for Health Information Technology,  is responsible for explaining HITECH Act requirements of ARRA to the rest of us.

Blumenthal has summarized it this way:

A key premise: information should follow the patient, and artificial obstacles – technical, business related, bureaucratic – should not get in the way. As a doctor, I have many times wanted access to data that I knew were buried in the computers or paper records of another health system across town. Neither my care nor my patients were well served in those instances. That is what we must get beyond. That is the goal we will pursue, and it will inform all our policy choices now and going forward. This means that information exchange must cross institutional and business boundaries. Because that is what patients need. Exchange within business groups will not be sufficient – the goal is to have information flow seamlessly and effortlessly to every nook and cranny of our health system, when and where it is needed, just like the blood within our arteries and veins meets our bodies’ vital needs.

The HITECH act is also about eliminating barriers to information.  What kinds of barriers exist?

In an article by Mitch Wagner from InformationWeek, the three big barriers this act  addresses are:

  • “Commercial barriers that “restrict the secure, private exchange of information required for patient care across provider or network boundaries. Some of these arrangements may improve care for those inside their walls. But ultimately, they have the potential to carve the nation up into disconnected silos of information…. Consumers, patients and their caretakers should never feel locked into a single health system or exchange arrangement because it does not permit or encourage the sharing of information.”
  • Economic barriers.
  • Technical barriers which limit interoperability. Information must ‘follow patients wherever they go.'”

(Full article can be found here: http://www.informationweek.com/blog/main/archives/2009/11/blumenthal_tear.html;jsessionid=YKGUW0H1G30TXQE1GHOSKHWATMY32JVN?cid=nl_healthcare_html)

So what about the funding aspect? Who gets the money?

From Ways and Means:

This legislation provides immediate funding for health information technology infrastructure, training, dissemination of best practices, telemedicine, inclusion of health information technology in clinical education and State grants to promote health information technology.

In addition, the legislation provides significant financial incentives through the Medicare and Medicaid programs to encourage doctors and hospitals to adopt and use certified electronic health records. Physicians will be eligible for $40,000 to $65,000 for showing that they are meaningfully using health information technology, such as through the reporting of quality measures. Hospitals will be eligible for several million dollars in the Medicaid and Medicare programs to similarly use health information technology.

You can read more about this at the link to Ways and Means, above.

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