| Federal Background |
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In February 2009, the Federal Stimulus legislation known as the “American Recovery and Reinvestment Act (ARRA) of 2009” was signed into legislation. The ARRA included the HITECH Act, a landmark ruling intended to usher in widespread adoption of electronic health records (EHR) with large federal financial incentives to hospitals and individual providers. Part of this legislation was allocation to the states for organizing and supporting EHR implementation as well as developing Health Information Exchanges (HIEs). “American Recovery and Reinvestment Act of 2009” Explanation of Health Information Technology (HIT) Provisions The ARRA provides substantial financial incentives ($19 billion over a specified five-year period) that will help physicians purchase and implement HIT systems. Beyond adequate financing, a key element to the widespread adoption and use of HIT is the development of uniform electronic standards that allow various HIT systems to communicate with each other. ARRA required the Department of Health and Human Services (HHS) to develop such standards. The ARRA authorizes the Centers for Medicare & Medicaid Services (CMS) to provide reimbursement incentives for eligible professionals and hospitals who are successful in becoming “meaningful users” of certified EHR technology. Beginning in 2011, Medicare physicians who implement and report meaningful use of EHR will be eligible for an initial incentive payment up to $18,000. While ARRA includes a provision that will reduce Medicare payments (starting at 1%) for physicians who do not use EHR systems, this does not take effect until 2015, and there are exceptions for significant hardship cases. “Health Information Technology for Economic and Clinical Health (HITECH)” The HITECH Act seeks to improve American health care delivery and patient care through an unprecedented investment in health information technology. The provisions of the HITECH Act are specifically designed to work together to provide the necessary assistance and technical support to providers, enable coordination and alignment within and among states, establish connectivity to the public health community in case of emergencies, and assure the workforce is properly trained and equipped to be meaningful users of EHRs. Combined these programs build the foundation for every American to benefit from an electronic health record, as part of a modernized, interconnected, and vastly improved system of care delivery. The HITECH Act provides HHS with the authority to promulgate regulations and guidance to support the development of an interoperable, private and secure nationwide health information technology infrastructure. “The Office of the National Coordinator for Health Information Technology (ONC)” The ONC is at the forefront of the HIT efforts and is a resource to the entire health system to support the adoption of HIT and the promotion of nationwide health information exchange to improve health care. ONC is organizationally located within the Office of the Secretary for the U.S. Department of Health and Human Services (HHS). ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced HIT and the HIE information. The position of National Coordinator was created in 2004, through an Executive Order, and legislatively mandated in the HITECH Act of 2009. Why Health IT? HIT allows comprehensive management of medical information and its secure exchange between health care consumers and providers. Broad use of HIT has the potential to improve health care quality, prevent medical errors, increase the efficiency of care provision and reduce unnecessary health care costs, increase administrative efficiencies, decrease paperwork, expand access to affordable care, and improve population health. Improving Patient Care Interoperable HIT can improve individual patient care in numerous ways, including:
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