Legislation Review Matrix

Healthcare Legislation

Healthcare Information Systems Legislation Since 2000

Health information technology has become a topic of discussion for healthcare organizations, professionals, and lawmakers in recent years as the government consigns tax dollars and presents legislation that will make new healthcare information systems more affordable and available over the coming years. Healthcare information systems innovators are also trying to design systems that are more user friendly and comply with the needs of multiple organizations. In 2004, President Bush signed an executive order which set a ten-year window on developing and implementing electronic health records systems across the United States (EHealthWV, 2004). Healthcare information technology had already been addressed in the HIPAA standards, some of which became law in 2001 and 2003 (Maruca, 2010). State legislatures began a concerted effort to address the issue of electronic healthcare systems in 2007, a year in which "74 bills were passed in 39 states and the District of Columbia" (HITCh, 2007). Besides the glut of state provisions, the American Recovery and Reinvestment Act of 2009 allocated more than $20 billion to different measures (HIMSS, 2009), and the Affordable Care Act of 2010 added further money and aid to the effort (Maruca, 2010. This net of healthcare information system legislation is an effort to solve the issues surrounding the implementation of this issue and they have done a credible job. However, there are still issues that need to be addressed.

Problem Statement

Healthcare information systems are put in place to aid the introduction of an individual's health information into a records keeping system. The old method of a nurse or other healthcare professional taking paper notes and assigning those to a folder is antiquated and problematic. It is very possible to make errors. It is difficult to share information with other professionals concerned with the patient's healthcare, and paper records are subject to quick decay. Many of these issues can be seen when people use health information technology also, but new generations are always trying to correct for these. The real problem with healthcare information systems legislation is that it creates a web of bureaucracy that sometimes makes it difficult to properly treat patients, and even more problematic security issues can cause a great deal of problems for patients whose information is entered into an electronic database.

Legislation and Solutions

When lawmakers are made aware of a problem they will often rush to create legislation, especially if a new technology can potentially harm constituents, rather than allowing the technology to mature so that they can determine what is the best course of action. Unfortunately, by the time this happens, there is a large web of healthcare legislation that, though out of touch with the technology, is still in force and may hamper efforts to move forward. This is an unfortunate consequence of legislation in general.

The first attempt to somehow regulate the new technology was contained in the law that created HIPAA. This act was created to make sure that patients medical records remained private and secure. Only people who needed to know the information contained in a patient's record were allowed access. Knowing that this would be complicated with the introduction of healthcare information systems technology, HIPAA does have a provision for the securing of electronic medical records also (Maruca, 2010). This legislation has been successful, but it has had to be amended several times as new technology becomes available.

In 2004, President George W. Bush talked about electronic health records in his State of the Union Address. He said then that he had signed an executive order (which is not technically legislation, but it is often followed as such) in which the goal was for most Americans to have electronic medical records by 2014 (EHealthWV, 2004). The initiative was enacted because it would streamline the records keeping abilities of the healthcare system, and make patient records more accessible across the breadth of the healthcare industry. This was an admirable goal that set in motion the next wave of legislation.

State's legislatures began addressing this issue soon after the President mentioned the problem in his State of the Union, and by 2007 many states had at least allocated funds for studies (HITCh, 2007). According to Mertz (2008), 44 states had enacted some type of law that allocated funds, implemented, or regulated health information technology initiatives. For example, Alabama created a new commission called the Health Information Technology Partnership (HITP) that is responsible for funding and overseeing HIT, Missouri established the Healthcare Technology Fund which "consists of all gifts, donations, transfers, and moneys appropriated by the general assembly, and bequests to the fund," and Virginia enacted legislation that would regulate and technology used in state institutions (HITCh, 2007). These various state laws were just the beginning as state legislators were anxious to ensure the progressive nature of their base of healthcare law.

The federal government tried to help people recover from the financial crisis of 2008 by instituting the American Recovery and Reinvestment Act of 2009. Within this Act were provisions for medical records and other healthcare information technology. According to the HIMSS (2009), "It includes over $20 billion to aid in the development of a robust IT infrastructure for healthcare and to assist providers and other entities in adopting and using health IT." This money was spread through many different agencies to make sure that it provided the most benefit to the most people. The purpose of the legislation was to stimulate the economy, and this provision was supposed to provide infrastructure building jobs in healthcare.