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HIMSS attendees consider a world without the HITECH Act

Jean DerGurahian

As stakeholders descend on the Sunshine State to listen to the latest in health care information technology, providers are questioning what they say are confusing objectives from the federal government regarding incentives for adopting technology.

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A bill proposed in Congress, the Spending Reduction Act of 2011 (H.R. 408), besides cutting other federal programs, would rescind unspent funds allocated through the stimulus law of 2009. That includes the Health Information Technology for Economic and Clinical Health (HITECH) Act, which mandates that hospitals and doctors adopt electronic health record (EHR) technology and meet meaningful use criteria to receive incentives.

H.R. 408 aims to cut $2.5 trillion from federal spending, a key initiative of Republicans this year. It is the first step in House Republicans' pledge to take spending back to 2008 levels and eliminate stimulus funds, said the Republican Study Committee in announcing the bill.

"The national debt has grown from $8.6 trillion four years ago to more than $14 trillion today," said Rep. Jim Jordan (R-Ohio) in a statement. "This mountain of debt, nearly the size of our entire economy, threatens to create a whole new financial crisis."

Among those cuts is the $20 billion or so of the HITECH Act aimed at giving providers incentives to adopt and use EHR technology. Eligible hospitals and providers will attest they are using certified technology to meet meaningful use criteria and receive payments through Medicare and Medicaid starting this year. Because some already have begun to implement EHR technology and budget for potential incentive payments, the loss of HITECH Act incentives would be a blow to the industry, providers say.

This discussion of how important providers believe the incentives to be to their EHR adoption comes as some 30,000 providers, payers, doctors and other stakeholders prepare to meet for the Healthcare Information and Management Systems Society's (HIMSS) 2011 annual conference and exhibition, to be held Feb. 20-24 in Orlando.

The HITECH Act regulations are a multibillion dollar bet that EHR technology can help transform health care, said Joel Berman, a physician who is chief medical informatics officer at Concord Hospital in New Hampshire. "It was a clear and unambiguous statement."

Rescinding the funds would be disruptive for providers who are preparing to attest they are meeting meaningful use criteria. "Achieving meaningful use is much more than purchasing a certified product and plugging it in," Berman said. "It's a huge emotional, financial and intellectual commitment."

Berman is presenting at HIMSS 2011. Concord Hospital, which has focused on IT projects since 2004, expects to be ready to meet meaningful use criteria this year in its outpatient setting, and is working to implement EHR in its inpatient setting in 2012.

Achieving meaningful use is much more than purchasing a certified product and plugging it in.

Joel Berman, CMIO, Concord Hospital

Providers already under way with implementations are expecting federal aid, according to Richard Sadja, chief financial officer at Family Practice of Glendale in California. The 15-physician practice and residency program expects it will spend $200,000 to $300,000 over time to implement EHRs. "That's a substantial sum," Sadja said.

The chance that the bill will lead to the end of the HITECH Act is slim, but the mandates have helped shape the discussion about technology in health care, Sadja said. "It's just a disappointment that Congress is looking at it in such a narrow focus."

The criteria and the accompanying certification standards for EHR products spelled out in the HITECH Act provided a clear path for the industry, according to Mark Segal, vice president for government and industry affairs at GE Healthcare IT. "There was a real reason for HITECH, and that reason continues."

Repealing the act would change the trajectory of EHR adoption among providers and send a "disturbing" message to an industry that has looked toward the government for leadership, Segal said, adding that boosting IT in health care has had broad support for the last decade. "I think there's widespread agreement on [the need for] delivery system improvements."

Let us know what you think about the story; email Jean DerGurahian, Executive Editor.


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