HealthAffairs: With one year down, ARRA has a lot on the line
Now that the American Recovery and Reinvestment Act (ARRA) is one year old, it’s time to ask if the federal government has gotten IT right, according to an editorial in the April issue of HealthAffairs.
“The fact is that $1 in every $5 in spending that ARRA authorized went toward the health sector in some fashion,” wrote Susan Dentzer, editor-in-chief of HealthAffairs.
“Faced with the grim facts that only about 6 percent of physicians and 2 percent of hospitals used full-blown EHRs, Congress and the Obama Administration decided on an appropriate inducement: cash," according to Dentzer, "[T]he law authorized carrots, in the form of bonuses through Medicare and Medicaid, for providers who could demonstrate meaningful use of electronic health records. It then fell to federal officials to define what ‘meaningful use’ constituted.”
“The utility of the entire taxpayer investment in health IT—which could run to $29 billion through 2016—will turn in large part on whether or not we get this definition right," Dentzer wrote. “The feds have received plenty of push-back on the draft regulation from hospitals and physicians arguing they’d be asked to do too much with health IT too soon.”
“There are important reasons to move forward with health IT aggressively—and also reasons to tread carefully,” she wrote. “Not all of the technology—let alone human capacity to make use of it—is yet where we need it to be.”
The HITECH Act isn’t about technology for its own sake, but rather about improving the quality and efficiency of healthcare, "not to mention improving health,' according to Dentzer. “HITECH provisions should turn out to be the first down payment on healthcare reform,” followed by another, the healthcare reform legislation. “These two big sets of changes will reinforce each other,” she wrote.
Interestingly, support for health IT has been mostly bipartisan, "at a time when overall health care reform is being enacted with purely Democratic votes," she wrote. "Maybe investing in health IT was just small enough of an idea to fly beneath the partisan radar. Or maybe it’s that rare issue, just arcane yet important enough so that the few politicians who understood it also grasped the imperative of leaving politics at the door.”
“The fact is that $1 in every $5 in spending that ARRA authorized went toward the health sector in some fashion,” wrote Susan Dentzer, editor-in-chief of HealthAffairs.
“Faced with the grim facts that only about 6 percent of physicians and 2 percent of hospitals used full-blown EHRs, Congress and the Obama Administration decided on an appropriate inducement: cash," according to Dentzer, "[T]he law authorized carrots, in the form of bonuses through Medicare and Medicaid, for providers who could demonstrate meaningful use of electronic health records. It then fell to federal officials to define what ‘meaningful use’ constituted.”
“The utility of the entire taxpayer investment in health IT—which could run to $29 billion through 2016—will turn in large part on whether or not we get this definition right," Dentzer wrote. “The feds have received plenty of push-back on the draft regulation from hospitals and physicians arguing they’d be asked to do too much with health IT too soon.”
“There are important reasons to move forward with health IT aggressively—and also reasons to tread carefully,” she wrote. “Not all of the technology—let alone human capacity to make use of it—is yet where we need it to be.”
The HITECH Act isn’t about technology for its own sake, but rather about improving the quality and efficiency of healthcare, "not to mention improving health,' according to Dentzer. “HITECH provisions should turn out to be the first down payment on healthcare reform,” followed by another, the healthcare reform legislation. “These two big sets of changes will reinforce each other,” she wrote.
Interestingly, support for health IT has been mostly bipartisan, "at a time when overall health care reform is being enacted with purely Democratic votes," she wrote. "Maybe investing in health IT was just small enough of an idea to fly beneath the partisan radar. Or maybe it’s that rare issue, just arcane yet important enough so that the few politicians who understood it also grasped the imperative of leaving politics at the door.”