Health Information Technology for Economic and Clinical Health (HITECH) legislation is now an act after signing into law on February 17 2009. The act promotes adoption and meaningful use of the health information technology. Under this act, the US Department of Health and Human Services spends over $25 billion to promote and expand the adopting of health information technology. During enactment, people considered it to be the most critical legislation on health care reform in 20-30 year.
A promise of maximum incentive payments to those who adopt and use certified electronic health records (EHR) for over six years starting 2011 is the reason for the popularity of HITECH legislation.
Difference between HITECH and other EHR programs
The significant difference between different programs and HITECH is that hospitals and physicians who install and use the infrastructure get to pay. The result makes it serve as a model for driving the adoption of the other valuable technologies. EHR adoption rates were low with slow increment rate until the HITECH Act.
It is approximately 10% of hospitals and 17% of doctors who were holding essential EHR before passing the ACT. The low number was due to the cost of implementation and a supposed lack of ROI. During that time, the Congress believed health IT could improve the quality of healthcare and efficiency of the healthcare systems. The law got bipartisan support although achieving all the primary goals is not to the level.
Reports on the HITECH Act show that an increase in HER adoption is something with direct attribution to it although it is unclear if there would have been an increase in adoption rates without financial incentives.
HITECH Act Meaningful Use standard
The HITECH Act meaningful use standard for an interoperable electronic health record is a significant part of the law. Centers for Disease Control and Prevention (CDC) groups "meaningful use standard" into these pillars:
1. Improving safety, quality, efficiency and reducing the health disparities
2. Engaging patients and their families in health Enhancing population and public health
3. Improving care coordination
4. Ensuring adequate privacy and the security protection for the personal health information
The implementation has been in three phases of issuing incentive payments through Medicare and Medicaid. Stage 1 ended in 2010, stage 2 in 2012 while stage 3 ended in 2015.
Evaluation Of HITECH Legislation Success
Years since the signing of HITECH Legislation into an act and implementation of the law has seen the policy achieve mixed successes. It was efficient in increasing the adoption rate of the electronic health records and technology. According to a report by The Milbank Quarterly, a journal on population health and health policy, the success of advanced functionalities such as population health management has no gone beyond the expectations.
The basis of the report is a review by researchers on qualitative and quantitative evidence of progress in five years after implementation of the HITECH Act implementation to evaluate the success of the program at the time. The research also focuses on identifying the key challenges. They found and that HITECH helped in carrying out of challenging and complex programs such as adoption of electronic data sharing, adoption of EHRs and using of the health IT generally to improve the healthcare delivery and outcomes.
Challenges of HITECH Legislation
Primary problems persist especially along the lines of supporting the advanced functionalities like population health management and patient engagement initiatives. It is also worth noting that the progress relating to electronic communication and interoperability. HITECH achievements have in some areas fallen short of expectations by the proponents due to challenges in moving meaningful use beyond the first low bar for the meaningful use stage
Achieving the goals of the HITECH Act requires developing an interdependent infrastructure and goals instead of using a step by step pattern such as beginning by adopting EHR first and figuring out interoperability later. The success and failure of EHR concerning HITECH legislation vary according to adoption by each within the practice.