The State of IT in Healthcare

Healthcare providers are poised to make significant investments in healthcare IT, in part because of the HITECH Act passed by the US Congress in 2009 (see “Impact of the HITECH Act” below). This investment by healthcare providers is ultimately intended to enhance patient care. But exactly what does “enhance patient care” mean? It’s a broad idea, and OpenText has partnered with renowned healthcare institutions to best define in practical terms what it means to them and their patient community, and how they can achieve higher quality patient care through the use technology, such as “healthcare IT.”

As a next step in the process of improving patient care, many healthcare providers are embracing and adopting healthcare IT technologies that focus on delivering Electronic Health Records (EHRs) throughout the continuity and continuum of care. To achieve the benefits of and ERH system, organizations must overcome two obstacles: First, they must deal with the challenges of reconciling, aggregating, and summarizing patient clinical information captured in the myriad of healthcare systems such as HIS, RIS, LIS, PACS, EMR, CPOE, and Practice Management, among others. Second, they must make the aggregated patient clinical data accessible to clinicians and patients receiving care.

Making data – such as the complete history of a patient’s medical record – available to clinicians is an important requirement for managing a patient’s clinical pathway. There is no question that clinicians want to prescribe the best procedures and clinical treatments for their patients, but a lack of information (or access to it) can stand in their way. Making information available to clinicians requires that organizations also resolve a number of other requirements, such as connectivity, security, aggregation, sharing of information, integration of disparate information systems, and reconciliation of clinical data.

Sources of Funding

Making the changes outlined above will require significant investment. Fortunately, healthcare organizations can take advantage of private and public funding available to finance their healthcare IT Initiatives. The main source for private funding is the Healthcare Payer; for public monies, the funding will come from the federal, state and provincial governments. Public funding in particular received a major boost when the US Federal government passed ARRA in 2009, which included the HITECH Act.

Impact of the HITECH Act

On February 17, 2009, the United States federal government signed into law the $787 billion American Recovery and Reinvestment Act of 2009 (ARRA), also known as “the Stimulus Bill.” This law includes some $20 billion to increase the use of Electronic Health Records (EHR) by physicians and hospitals. This portion of the bill is called the Health Information Technology for Economic and Clinical Health Act, or the HITECH Act. The US government firmly believes in the benefits of using electronic health records and is investing substantial federal resources to increase their use.

Synopsis of how the HITECH stimulus funds are being spent:

$18 billion through the Medicare and Medicaid reimbursement systems as incentives for hospitals and physicians who are “meaningful users” (see below) of EHR systems.
$2 billion to the Office of the National Coordinator for infrastructure necessary to allow for, and promote, the electronic exchange and use of health information for each individual in the United States; updating the Department of Health & Human Services’ technologies to allow for the electronic flow of information; integrating health IT education into the training of healthcare professionals; and, promoting interoperable clinical data repositories.
$1 billion to be made available for renovation and repair of health centers and for the acquisition of health IT systems.
$550 million for – among other things – the purchase of equipment and services including, but not limited to, health IT within Indian Health Service facilities.
$400 million for comparative effectiveness research on how use of electronic data impacts healthcare treatments and strategies.
$300 million to support regional and sub-national efforts towards health information exchange.
$40 million to be used by the Social Security Administration to use EHRs to submit disability claims.

“Meaningful use” Documents

The following is a list of more information about “meaningful use” as it pertains to healthcare.

From the Office of the National Coordinator for Health Information Technology (ONC):

ONC has issued an Interim Final Rule (IFR) that specifies the Secretary’s adoption of an initial set of standards, implementation specifications, and certification criteria for electronic health record technology.

ONC previously issued the Meaningful Use Notice of Proposed Rulemaking (NPRM) that announced the process for generating the rules.
In June 2009, ONC staff identified a subset of providers eligible for incentive payments who were likely to have different needs of their EHRs than primary care providers (e.g., specialists and non-physician providers). ONC convened brief calls with representatives from these provider groups to promote a better understanding of how EHRs and meaningful use would impact their work.
Summary of 6/09 Comments from Non-physician and Specialist Physician Providers

From the Centers for Medicare & Medicaid Services (CMS):

Details for: Medicare and Medicaid Health Information Technology: Title IV of the American Recovery and Reinvestment Act

From the Health IT Policy Committee:

August 14, 2009 meeting

July 16, 2009 meeting

From the Health IT Standards Committee:

August 20, 2009 meeting

From the National Committee on Vital and Health Statistics (NCVHS):

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