If Congress hadn’t passed the American Recovery and Reinvestment Act of 2009 a year before health care reform, the new law’s technology provisions might have looked very different.
ARRA pumped $25.8 billion into health care information technology, including $19.2 billion as incentives for doctors and hospitals that make “meaningful use” of IT, plus grants for work force training, regional “extension centers,” regional-exchange development, and more.
With this huge cash infusion, combined with detailed new standards that are still being finalized, the stimulus bill “will really determine the path of [health care IT]” in the coming years, as Dr. Cedric J. Priebe, chief information officer for Care New England, put it.
But make no mistake: health care IT, or HIT as it is commonly referred, is a big part of the reform law as well – just in a different way.
“There are [more than] 50 provisions in this bill that reference use of HIT,” said Laura Adams, president and CEO of the Rhode Island Quality Institute, which has led local IT adoption efforts, including the creation of a statewide information exchange known as currentcare.
Parts of the reform law address HIT-adoption directly, Adams noted, such as a grant program to encourage long-term care facilities to use electronic health records. But more notably, HIT is part of provisions about delivery-system redesign, quality improvement and innovation.
“If we didn’t clearly understand the foundational role of HIT before, we certainly do now,” Adams said, “because it’s repeated throughout this bill, how it’s going to be used to reform the health care system.”
To some extent, the reform law presumes that doctors and hospitals will have the technology they need, Adams said, “but there’s also a nod to the fact that we aren’t quite there.” So while under ARRA, the government is setting standards for “meaningful use,” the new law includes grants and pilots that apply HIT along those lines, such as to measure outcomes and costs.
The law also creates a Center for Medicare and Medicaid Innovation, she added, that will provide even more opportunities to develop and expand programs that use HIT as a tool in delivery-system redesign and quality improvement.