Dr. David Blumenthal, the national health IT coordinator, said that he wants to "stretch" the healthcare community but not "break" it in setting the conditions under which providers can qualify for financial incentives to use health IT.
That's how he described how his office will determine how high to set the bar for physicians and hospitals to become "meaningful users" of electronic health records. Blumenthal spoke at a joint presentation of the Health IT Government Leaders, Health Information Ex change and HIPAA summits Feb. 4.
The proposed rule uses an escalator concept, which guides providers toward increasingly sophisticated uses of EHRs with the help of financial incentives and support from health IT technical training centers and state health information exchanges.
The administration wants to encourage the participation of physicians and hospitals in the program and prevent their dropping out once they've started, Blumenthal said.
"We don't want them jumping off halfway and rushing back down because we're moving too fast or the steps are too high. We also don't want them to move the equivalent of a level walkway through an airport either where they basically end on the same level that they started," Blumenthal said.
The Health and Human Services Department, which published the proposed rule last month, is accepting comments until March 15 and will finalize the plan in late spring.
"We are expecting lots of comments, and we will take those comments seriously," he said.
Blumenthal said he believed that the management of health information will become a core 21st century professional competency. "Once we have established that, there will be no holding back the profession in innovating and moving forward with health information technology," he said.
The wide adoption of electronic health records will boost the potential of the population research that the Agency for Healthcare Research and Quality (AHRQ) has conducted using a variety of databases, such as those that hold claims data over an extended period, said
Dr. Carolyn Clancy, director of the Agency for Healthcare Research and Quality, said wider adoption of EHRs holds the potential for dramatically improving population health research.
The agency wants to expand funding of research that uses distributed data networks, collections of databases (including EHRs) joined by a common data infrastructure.
"That's how we can begin to rapidly accelerate taking advantage of the capabilities of health IT for research," Clancy told the conference.
The challenge is how to make sense of all the information available in order to use it effectively, Clancy said, such as whether to use text messaging to provide health alerts to patients.
"Health IT is critical and indispensable but people have to organize the information. That is really the promise of patient-centered health research," Clancy said.
