Electronic technology will soon be considered as fundamental to medicine as the stethoscope, according to National Coordinator for Health Information Technology David Blumenthal, MD.

Federal incentives for the meaningful use of such technology will propel the nation, Blumenthal told a crowd of providers, technologists, vendors and advocates during a Tuesday morning speech at the Massachusetts Institute of Technology in Cambridge.

"I found that (information technology) changed me as a physician. I thought it was going to change practice. That was 10 years ago," Blumenthal said. "I think that reality will be realized within a few years."

Blumenthal's opening keynote at the HIT Symposium at MIT focused on the transformational potential of stimulus funds marked for healthcare IT initiatives. He emphasized the sheer size of the funding, which is between $31 billion and $46 billion depending on certain factors such as adoption levels and provider qualifications.

"The American Congress doesn't produce more than incremental change very often, but the HITECH provision is discontinuous – it's a leapfrog over the current state of affairs," he said. He qualified this statement with a reminder that President Barack Obama considers the funding a "downpayment" on healthcare improvement.

Despite attendees' enthusiasm for the Obama administration's focus on healthcare IT, some expressed anxiety over the short timeline for adoption and incentives. "If you look at the calendar and think about the institutions we need to create by 2011, it is a truly daunting prospect," Blumenthal said. "And in some ways, if we started a year ago, we'd still be late."

Blumenthal acknowledged other challenges facing the ONC, such as addressing the needs of small providers, privacy and security concerns and the lack of attention the current legislation pays to providers of long-term care, home care and hospices. ONC hopes to include those providers later, he said.

"We need that connection, but very frankly we don't have the resources or the authority in this legislation to do what we need to do in that sector," he said.

Blumenthal said he's optimistic about ONC's ambitious agenda. "We will not be successful unless we think of this as something with the purpose of changing individual health, population health and the efficiency of our healthcare system," he said. "That's the brilliance of the meaningful use concept: To set goals that are about healthcare, and not about information technology."

ONC's 2009 objectives include holding further policy and standards committee meetings, holding open meetings on certification processes, releasing a concept for infrastructure programs and issuing an initial rule on "meaningful use" by the end of the calendar year. 


Regarding the final definition of "meaningful use," Blumenthal said the initial rule would hit the federal register in December. A 60-day commenting period will follow, and in early- to mid-2010 there will be a final rule for 2011.

"(Meaningful use) is going to be an evolving concept," he said, noting that by Congressional intent, the definition will change to demand more of the nation's healthcare system.