It squarely tackles the commercial barriers. The HITECH Act calls for the "development of a nationwide health information technology infrastructure that allows for the electronic use and exchange of information and that ... promotes a more effective marketplace, greater competition (and) increased consumer choice," among other goals (Section 3001(b)). This means we cannot support arrangements that restrict the secure, private exchange of information required for patient care across provider or network boundaries. Some of these arrangements may improve care for those inside their walls. But ultimately, they have the potential to carve the nation up into disconnected silos of information, and thus, to undermine the vision of a secure, interoperable, nationwide health information infrastructure, which the law requires us to establish. Consumers, patients and their caretakers should never feel locked into a single health system or exchange arrangement because it does not permit or encourage the sharing of information.

It tackles the economic barriers. The HITECH Act incentives for providers and hospitals are powerful tools.  While the official definition of "meaningful use" won't be finalized until next year, the HITECH Act specifically highlights "information exchange" as one requirement for the incentives.

It tackles the technical barriers. The HITECH Act focuses on "interoperability" or "interoperable products."  In plain English, this means that our policies, programs and incentives must aim for electronic health record (EHR) software and systems that can share information with different EHRs and networks so that information can follow patients wherever they go. And to build the pipelines to carry this information, HHS is directed to invest in the infrastructure to "support the nationwide electronic exchange and use of health information ... including connecting health information exchanges" (Section 3011). This means we will work with all our partners in the health and IT industries and with organizations that are committed to information sharing to develop the technologies and policies that can help us deliver information securely, privately and accurately to whomever needs to see it on behalf of the patient's health. We must ensure interoperability for the future.

It provides building blocks for information exchange across jurisdictions. The grants for states and state-designated entities in Section 3013 – which will total $564 million – target information exchange across boundaries, not only within each state but explicitly as part of a nationwide framework. We will start announcing the awards this winter. These grantees' activities must support interoperability that lets patient data follow the patient across political and geographic boundaries. The grantees will be our partners in building the nationwide infrastructure mentioned previously.

In short, the HITECH Act not only authorizes but requires us to mobilize all our policies, programs and incentives to give the American people the patient-centric care they deserve and expect. I look forward to engaging all our partners in this unique opportunity.

Regards,

David Blumenthal,
MD, MPP
National Coordinator for Health Information Technology
U.S. Department of Health and Human Services