Going forward, Social Security will focus on two areas. Social Security is looking to expand the number of healthcare providers and health information exchanges, and state disability determination services that are currently using MEGAHIT, its Medical Evidence Gathering through Health IT application. Of the up to $40 million of the American Recovery and Reinvestment Act funding that Social Security was authorized to spend for health IT, the agency will use $24 million to expand the use of its MEGAHIT project. Social Security expects to release the RFI and RFP this summer and make awards by late 2009 or early 2010, Borland said.

Social Security will also continue its efforts to identify parts of the disability process internally that can be made more efficient through the use of health IT.

"We update medical evidence at various steps in our disability determination process as well as during continuing disability reviews," Borland said. "We think there are applications of health IT that can make other parts of the disability process more efficient."

Social Security's vision of its health IT efforts and MEGAHIT project is analogous to electronic wage reporting, Borland said. Today, 82 percent of W-2 forms are received electronically.

"It's going to be a process by which we ramp up closer and closer to fully interoperable shared, structured electronic health records, much as we ramped up to e-wage reporting," he explained. "If we're at 82 percent of all medical information being gathered electronically through structured, interoperable EHRs in 10 years, I think this agency will be much more efficient."

Borland said he hoped the incentives within the HITECH Act would drive physician adoption of interoperable health records, which would then enable them to interact with Social Security and provide it with structured medical data.

"We believe that Social Security - because of our technical leadership in health IT - is in a position to prove the business case for health IT," Borland said.