With healthcare reform teetering in Congress, patients, doctors, nurses, insurance companies and employers should be grateful that one critical piece of reform has already begun to work.
The HITECH portion of the American Recovery and Reinvestment Act (ARRA) provided millions of dollars to make a big difference in care.
Already hospitals and physician practices are moving more swiftly than before to make their way from paper-based to digital healthcare as they work to meet the meaningful use criteria attached to the funds. A minimum $2 million boost for hospitals is substantial incentive.
How wise to make those funds and programs available in an emergency federal stimulus package that was not as likely to suffocate in Congress as insurance reform seems in danger of doing.
The stimulus package is where the information technology funds belong. Information technology carries the promise not only of improved patient care, but also of more efficient, less costly care.
In 2008, the United States spent $2.3 trillion on medical care, or 16.2 percent of gross domestic product and $7,681 per person, according to government estimates.
If the use of information technology were to significantly reduce the cost of care – as we believe it would – that would be stimulus indeed.
We need comprehensive healthcare reform. That our government leaders have yet to forge an agreement over this for 70 years is bitter pill to swallow.
The HITECH funds – and the anticipated results – sweeten the pill a little. But, even this apparent boon carries with it big responsibilities.
If it wasn’t obvious before, it’s now painfully clear that change – as exhilarating and promising as it might be – is hard work.
Even healthcare organizations that are recognized pioneers in the use of information technology are struggling with some aspects of meaningful use criteria in Stage 1.
At a recent forum in San Francisco, Richard Roth, senior director for strategy and business development at Catholic Healthcare West, told attendees the meaningful use criteria were “too high and too many.”
James Ferguson, executive director of health IT strategy and policy for Kaiser Permanente, an organization that holds up its HealthConnect EHR as a shining example of what technology can do, said there was probably no health system today that was doing exactly what will be required by Stage 1 meaningful use criteria.
Intermountain Healthcare in Salt Lake City identified the need to fill 26 of the 61 Stage 1 criteria, and 19 of the 29 criteria for security and privacy, according to Len Bowes, MD, senior medical informaticist.
The proposed rules – 700 pages in total – were designed to budge an awkward behemoth of a healthcare system (former HHS Secretary Michael Leavitt said you couldn’t really call it a “system”) that is still weighed down in paper.
The rules may be tough to navigate, but they are not final. At a meeting of the Health IT Standards Committee Jan. 20, the nation’s healthcare IT chief David Blumenthal, said public comments would help reshape some of the provisions.
"We want to get it as right as possible," Blumenthal said. "I would not hold back any comments because you think they are irrelevant. If it's within the scope of the regulation, we want to hear about it and we'll try to get it right."
The comments will help shape the final rules. The comment period is open through March 15.
So comment, and keep the vision front and center.
“Meaningful use will really improve health,” said Catholic Healthcare West’s Ferguson. It will provide the "ability to make the right thing easy to do.”
John Halamka, MD, CIO at Beth Israel Deaconess Medical Center and at Harvard Medical School in Boston, has been working on these issues for years. He has high hopes, and we all should.
“As we navigate the stages of meaningful use in the years ahead,” says Halamka in a recent blog, “be prepared for amazing shifts in workflow, process, and behavior that will accompany them.”
