WASHINGTON – Experts and federal officials close to the issue of healthcare IT adoption and the promotion of meaningful use under the new stimulus package say intentions are high, but the actual work that lies ahead is monumental.
They were gathered at the 2009 Annual Conference of the Agency for Healthcare Research and Quality, held Sept. 13-16 in Washington D.C..
"I've been in this field for decades, and the interest in health IT has never been stronger," said Mark Spranca, a healthcare IT expert with Abt Associates.
According to Abt, physicians who have adopted healthcare IT may not be using it in a meaningful way yet.
"There is lots of room for improvement in healthcare IT adoption," Spranca said. "Meaningful use is important, but we still have to focus on adoption. The industry needs to take meaningful use from a concept to an empirical reality, which is right now incomplete and somewhat inconsistent. We need to build electronic health records to monitor outcomes we care about."
Spranca recommends that policymakers keep an open mind when developing strategies to implement the HITECH Act found in the stimulus package. "We might need course correction to enable the incentives providers will need," he said.
Tony Trenkle, director of the Centers for Medicare and Medicaid Services' Office of e-Health Standards and Services, said adoption of healthcare IT by 2011 will be a tough task to accomplish, but "Interest has never been higher."
According to Trenkle, the HITECH Act provisions found in the American Recovery and Reinvestment Act (ARRA) are aimed at increasing healthcare IT adoption, but they are also part of a bigger picture to lay an infrastructure for the future of U.S. healthcare.
Lawmakers intended the government to launch healthcare IT adoption through incentives in government programs like Medicare, Medicaid and the State Children's Health Insurance Program. "CMS will play a key role," Trenkle said. "We are the big enabler to make this work."
Provider incentives for meaningful use of healthcare IT, scheduled to begin in 2011, is just a start, Trenkle said. "We know we aren't going to be where we need to be in 2011, but it will set the stage," he said. "Key dates for adoption will be 2015, 2017, 2019 and beyond."
Trenkle said he isn't surprised that HITECH passed in February, but he is surprised at how fast it passed. "It will be a game changer. It has potential to bring about vast changes," he said.
CMS officials will be issuing a proposed final rule on meaningful use by the end of the year, with the final rule to come out some time in early 2010.
Trenkle said he expects thousands of comments on the rule when it comes out. The challenge will come as the CMS strives to sync its efforts and create a platform for expansion without creating disincentives for physicians or unintended consequences.
"This is going to be an experiment, in some ways, on a very large scale," he said.
Micky Tripathi, CEO of the Massachusetts eHealth Collaborative, said even with incentives under the HITECH Act, physicians who adopt healthcare IT will likely have to shell out $21,000, even if they are able to qualify for the most incentives possible. There are long-term benefits to using healthcare IT, he said, but by necessity, physicians are often focused on their bottom line.
Floyd Eisenberg, senior vice president of healthcare IT at the National Quality Forum, said the federal HIT standards committee will begin retooling 17 NQF measures on Sept. 21 to form a basis of the standards needed for meaningful use.
"We will be trying to connect the dots between clinical guidelines, quality measures and decision support," he said.
