Every year, the HIMSS annual conference has provided a milestone on our journey toward a future of HIT-assisted healthcare. Every year we’ve seen progress. Yet past years have been marked by the stubborn gap between the potential we perceive for HIT-assisted care and a sluggish rate of adoption among providers.

This year, the landscape is truly changing. In the last 12 months, our progress has taken on a transformative quality.

Programs authorized by the HITECH Act of 2009 are now fully in place:
•    Last July, HHS finalized its regulations defining meaningful use, including Stage 1 (2011-2012) objectives for providers, plus certification requirements for vendors.
•    In the last 12 months, the ONC launched a nationwide network of 62 Regional Extension Centers that now offer customized, on-the-ground assistance to providers (especially smaller primary care practices and hospitals) as they switch from paper-based records.
•    HHS is supporting community college programs to train 40,000 new HIT specialists.
•    We designated 17 regional Beacon projects to demonstrate how HIT can help coordinate care, involve patients and achieve high-priority local health needs.

Last month, the Centers for Medicare & Medicaid Services opened registration for providers to qualify for incentive payments when they adopting EHRs and achieve meaningful use objectives. HITECH authorizes up to $27 billion in incentive payments over 10 years. That can mean as much as $44,000 per physician or other eligible provider through Medicare; or $63,750 through Medicaid; and $2 million or more for hospitals.

The first payments to providers were actually made in early January.

This is a very significant level of new support. The combination of financial incentives plus technical assistance and leadership is bringing about new movement in the provider community. Recently-released surveys are beginning to tell the story:
•    The National Center for Health Statistics (NCHS), an agency of the CDC, reported in a survey published in December that adoption of a basic EHR by primary care physicians increased 50 percent from 2008 to 2010 – from 19.8 percent to 29.6 percent.
•    Further NCHS data released in January shows that as of late 2010, 41 percent of office-based physicians were already planning to achieve meaningful use of EHRs and qualify for incentive payments. Most of those (about a third of all office-based physicians) were planning to qualify for payments in Stage 1 of the program, 2011-2012.
•    Another survey from the American Hospital Association shows that 81 percent of hospitals expressed their intent to qualify for incentive payments, with about two-thirds expecting to act in Stage 1.
What has changed most of all in the HIT environment can be summed up in one word: “alignment.” That is the core principle of our meaningful use approach.

Incentive payments are aligned with the required objectives, and the objectives in turn help guide the provider in realizing the new potentials of EHR-based care. The objectives are also aligned with certification requirements for EHR systems, so that providers can have confidence that when they invest in certified systems, those systems will support the meaningful use requirements. 

Further, over the three stages of the meaningful use process, objectives will escalate gradually to help the provider to continue pursuing and successfully complete the EHR conversion journey. And these objectives will be aligned with achievements of national goals for quality reporting, safety improvement, secure information exchange, privacy protection and support of continual learning.

Our goal has been to translate the nation’s goals for improved care through HIT into achievable, affordable, and well-supported steps that are within the capacity of every provider. I believe we are seeing evidence already that this approach is working.

By David Blumenthal, MD, MPP,
National Coordinator for Health Information Technology