There’s more to HIT than EHRs
For all the sound and fury from anti-government conservatives about the stimulus package, it does sometimes seem surprising that ARRA's $27 billion HITECH plank hasn't attracted more flack from certain folks on the right.

But Chilmark Research analyst John Moore reasons that the EHR incentives are "such a small, small piece of that massive program" that it's almost akin to "the flea on the back of the dog."

Still, he said, "what I do think is in jeopardy is if HHS does not show strong adoption – some positive things coming out of the HITECH Act, and continued traction – then that might come back to haunt them."

Luckily, "right now, CMS is posting some pretty good numbers with regard to adoption, growth, attestation," Moore said. "So, with EHR adoption the lion's share of the HITECH Act, I think that's probably going to be pretty safe."

On the other hand, with certain HITECH programs, such as the Beacon Communities and some of the state HIEs and HIXs, "there's a little more reason for concern," he said.

Indeed, sustainability will be a huge issue for state-level HIEs and HIXs in the coming years. A soft economy and fractious political landscape don't do anything to help that issue.

Mariannette Miller-Meeks, MD, director of Iowa's Department of Public Health (IDPH), says that, in her state, at least, "a great many people" see healthcare IT "as a bi-partisan issue."

While certain factions might have their "concerns" about government-spurred initiatives, she told Government Health IT, "they also see the ramifications and cross-savings that can occur" by sharing data, preventing duplication of tests and services.

That said, there are lessons to be drawn, not just here but abroad. Just look at England's massive, government-designed interoperability project, the National Programme for IT (NPfIT). Launched by the Labour party in 2002, it was essentially dismantled by the new Conservative party this past year after a disheartening, decade-long string of failures.

Politics weren't the program's biggest problem, but it's hard to miss the rueful schadenfreude in this headline from the website of the right-leaning Daily Mail: "£12bn NHS computer system is scrapped... and it's all YOUR money that Labour poured down the drain."

Will we be seeing similar news stories in the U.S. in the coming years? Marc Willard, CEO of San Jose, Calif-based Certify Data Systems – and an English expat – is no fan of the top-down NPfIT. But he doesn't think so. "Whether Republicans or Democrats are elected in this year, I don't think a lot is going to change around healthcare IT," he said. "At the end of the day, health systems have to connect to their physicians."