Blumenthal: Health IT investments in U.S. should bolster infrastructure

The provisions of the Health IT for Economical and Clinical Health (HITECH) Act are best understood not as investments in technology per se but as efforts to improve the health of Americans and the performance of their healthcare system, wrote David Blumenthal, MD, the head of the Office of the National Coordinator for Health IT (ONC), in a perspective published in the Dec. 30, 2009 edition of the New England Journal of Medicine.

“Information is the lifeblood of modern medicine,” wrote Blumenthal. “Health IT is destined to be its circulatory system.”

The effort to achieve meaningful use provides the best lens to understand the government’s actions in implementing the HITECH Act, according to Blumenthal.

In the article, he wrote that the Obama administration is trying to achieve four basic goals:
  • Define meaningful use;
  • Encourage and support the attainment of meaningful use through incentives and grant programs;
  • Bolster public trust in electronic information systems by ensuring their privacy and security; and
  • Foster continued health IT innovation.

The publication on Dec. 30, 2009 of a notice of proposed rule-making (NPRM) on Medicare and Medicaid’s EHR Incentive Program is part of defining meaningful use. Currently, the proposal has been issued and is open for public comment for a period of 60 days.

While a step towards defining meaningful use is a step forward, Blumenthal noted that other elements must fall into place to improve processes of care and outcomes. “Multiple studies have shown that healthcare providers need help overcoming several key obstacles to adopting and using health IT,” wrote Blumenthal. “Many lack the technical expertise to pick the right health IT systems and use them in ways that will improve care."

Additionally, he acknowledged that no infrastructure exists in most areas of the country for secure health information exchange among providers and between providers and consumers.

Blumenthal mentioned that eligible healthcare providers can generally earn up to $44,000 in extra payments between 2011 and 2015 if they become meaningful users of EHRs.

Blumenthal also wrote that “the government has committed almost $650 million under the HITECH Act to the creation of a network of up to 70 regional health IT extension centers” to overcome providers’ technical and logistic problems as well as dedicated “$560 million in HITECH Act monies to state governments to lead the development of exchange capabilities within and across their jurisdictions.”

Recently, ONC announced a $60 million research program designed to encourage progress in health IT’s capabilities and usability, he said.

“The government’s program for creating a 21st Century health information system is complex and it will continue to evolve as we learn more about the effects of the HITECH Act’s implementation,” concluded Blumenthal. “One thing is clear, however. It is impossible to imagine a high-performing U.S. health system that does not take full advantage of the computing technology that has transformed virtually every other aspect of human endeavor.”

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