A long, long time ago, way back in 2007, "presidential candidates in both parties were pledging to boost health IT," writes TIME magazine reporter Michael Grunwald in his book, The New New Deal: The Hidden Story of Change in the Obama Era (Simon & Schuster). "Several bipartisan bills were floating around Congress, and Hillary and Newt Gingrich were both hailing electronic medicine as the future of healthcare." 

A long, long time ago, way back in 2007, "presidential candidates in both parties were pledging to boost health IT," writes TIME magazine reporter Michael Grunwald in his book, The New New Deal: The Hidden Story of Change in the Obama Era (Simon & Schuster). "Several bipartisan bills were floating around Congress, and Hillary and Newt Gingrich were both hailing electronic medicine as the future of healthcare." 

Still, five years ago, all that talk and more or less toothless legislation had still failed to make much of an impact on what Grunwald calls "the world's least data-driven $2 trillion industry" (see the Q&A with him on page TK). "Every minute, redundant new tests were ordered because old results weren't instantly available," he writes. "Nurses and doctors wasted countless hours filling out and searching for paperwork, and atrocious paperwork still killed."

But in late 2008, in the span of just two months, the great recession brought the U.S. economy to the brink of catastrophe, and Barack Obama was elected president. Before long, the American Recovery and Reinvestment Act (ARRA)  -  the $800 billion stimulus whose contentious construction on Capitol Hill and nationwide legacy are the subjects of Grunwald's book  -  was in the works. 

"Never waste a crisis," erstwhile White House Chief of Staff Rahm Emanuel was wont to say. And so, in response to the sharpest economic downturn since the Great Depression, was hundreds of billions of dollars directed toward investments in energy, education, infrastructure and much more  -  both for immediate "shovel-ready" stimulus and "down payment[s] on long-term goals."

A not-insignificant pillar of that omnibus bill, of course, was the Health Information Technology for Economic and Clinical Health (HITECH) Act, which earmarked some $27 billion for electronic health records (EHRs) and other health IT adoption. "Like energy efficiency, health IT was the kind of no-brainer that appealed to Obama's hyperrational side," writes Grunwald. "It seemed absurd that German doctors used laptops while American doctors used clipboards."

Sure, there had been strong (and bipartisan) support for health IT on Capitol Hill for a long time. But until the financial crisis, "a slew of competing bills had stalled over disagreements over how to protect patient privacy, how to get doctors and hospitals to go digital, and how to get computer systems to talk to each other," he writes.

ARRA  -  finally  -  helped force the issue. "People had been squabbling over the details for several years," Grunwald tells Healthcare IT News. "The prospect of $27 billion really did focus the mind." 

It's hard not to wonder where we'd be if the stimulus bill  -  and the meaningful use program it put into motion  -  had never happened. Rich Hodge, senior director of congressional affairs at HIMSS, has a good idea.