The federal government's multi-billion-dollar investment in health information technology through the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 has the potential to make measurable improvements in the nation's health care system, according to a report assessing the impact of the legislation thus far.

The first comprehensive review of HITECH, which was a key part of the American Recovery and Reinvestment Act of 2009, points to the need for a number of course corrections to ensure that the transformative potential of the Act is reached. The report was prepared by Manatt Health Solutions and supported by the California HealthCare Foundation, The Colorado Health Foundation, and the United Hospital Fund.

The report, informed by interviews with 24 leading health IT experts, provides a candid assessment of the progress made to date, the challenges that lie ahead, and what specific actions Congress and the Obama Administration should take to achieve HITECH's ambitious goal of jump-starting the adoption of health IT in the health care industry.

Key findings of the report include:

1. Without a roadmap, the three-stage release of "meaningful use" criteria makes it difficult for health care providers to build achievable health IT strategies or to buy the most appropriate products. Currently only stage-one standards have been released and the entire standard is not scheduled to be finished until about 2015.
2. Eligible health care providers, especially small and rural practices and certain community health centers, may have difficulty meeting the proposed "meaningful use" criteria, which may result in EHR adoption rates that are less than anticipated.
3. The approach being proposed to allow different health IT systems to communicate with each other — called "interoperability" — is unlikely to yield quality improvement and cost efficiency gains.
4. Stronger policies to encourage clinical practices to use evidence-based treatment guidelines consistently are necessary to ensure improvements in patient health outcomes.
5. It is important to allow states to use "meaningful use" requirements as a policy lever to drive improvements in the care provided by Medicaid programs. State-specific "meaningful use" objectives should apply to all eligible hospitals and professionals receiving Medicaid EHR incentive payments, provided such objectives advance Medicaid interoperability and quality improvement goals.
6. To enable truly coordinated care across all settings, new legislation is needed to make currently excluded health care providers (for example, long term care and behavioral health providers) eligible for the Medicare and Medicaid EHR incentive programs or to authorize separate funding to support EHR adoption and ongoing use by such providers.
7. Regional Extension Centers, created to assist provider organizations in meeting "meaningful use" requirements, may face sustainability and operational challenges, making it important to develop alternative approaches to ensure the provision of EHR adoption and implementation support services.
8. HITECH is a necessary but not sufficient step to achieve greater quality and efficiency in health care. Building on the recently passed Affordable Care Act, additional policies should be developed, targeted especially toward Medicaid and the commercial health insurance markets, to encourage physicians and hospitals to organize into systems of care that deliver high performance through the use of health IT. 

The full report, titled HITECH Revisited, is available on the Manatt Health Solutions Web site through the External Link below.