Since the passage of the HITECH provisions of last year’s ARRA, the Obama administration has taken significant steps in several directions toward hastening the implementation of new HIT across the healthcare sector.
But while it seems safe to say those steps will bear considerable fruit in the years ahead, a series of recent stories raises the question of how many directions policymakers can go in at once and still be effective.
To review chronologically, last month, “President Obama signed into law legislation that allows physicians who treat patients in hospital-based outpatient clinics to be eligible for incentive payments under the HITECH Act.” As a result, “many more physicians” will potentially become eligible for the HITECH incentives.
Around the same time, a bill was introduced in Congress that “would make behavioral and mental health professionals eligible to receive incentive payments for the meaningful use of electronic health records.”
More recently, ONC Director Dr. David Blumenthal “ has asked his advisors to turn to one of the most vexing problems on the health reform horizon: streamlining federal and state systems for enrolling people applying for health insurance benefits under the law.”
Specifically, “Blumenthal asked members of the Standards Committee at a meeting April 28 to start to develop standards for exchanging eligibility and enrollment data electronically between what is now a hodgepodge of federal and state health and social health programs and services organizations.”
Taken individually, these steps all make obvious sense, but it seems fair to wonder what the impact of these new developments will be on ONC’s initial strategic plan, which led, for one thing, to the HITECH provisions. In other words, policymakers presumably had at least a rough idea of the outcomes they would get – the level of change they would achieve across the healthcare sector – based on the HITECH investment. But expanding the pool of potential incentive recipients means that that investment will be stretched in more ways than previously planned.
So have policymakers calculated how the investment shift will impact their initial goals?
Just as importantly, how will ONC’s new involvement in implementing the recently passed healthcare reform law dilute its focus on its efforts stemming from HITECH? Unless the office is bringing on new staff to help shoulder the added burden, the management of ONC’s current efforts can’t help but be impacted. But by how much?
As one observer puts it “ONC has done an incredible job on a tight deadline, but it’s still far from completing its work” when it comes to the implementation of new HIT. Now, however, the “agency will begin work on another project that is nearly as big and ambitious as the EHR initiative.”
In short, stretching both financial and human resources in previously unanticipated ways is bound to dilute the effectiveness of policymakers’ current efforts. That’s not to say ONC shouldn’t go down these new paths; the fact is, they don’t have much choice.
But in the interest of communicating clearly with healthcare stakeholders, as well as remaining accountable to the taxpayers that are footing the bill, ONC should assess the impact of its new directions on its current programs. And it should share the results of that assessment with the public.
Jeff Rowe blogs daily at Priming the Pump.
