Health Information Technology for Economic and Clinical

¶ … Health Information Technology for Economic and Clinical Health Act (HITECH) was enacted as part of the 2009 bailout. The focus of the act is initiating "incentives related to health care information technology…and specific incentives designed to accelerate the adoption of electronic health record systems among providers (No author, 2013).

There has been a longstanding push to implement electronic health records in the U.S. health care system, for a variety of reasons. The Obama Administration has placed special emphasis on EHR, not only with HITECH but also in the Affordable Care Act as well. Arlotto (2010) outlines seven strategies for improving HITECH readiness in health care organizations. These are to invest in transformational infrastructure; build clinical information expertise; develop a business intelligence strategy; invest in physician business services infrastructure; explore a medical trading area health information exchange; and develop an e-strategy for engaging patients.

These tactics are designed to help health care companies meet the objectives of HITECH, something that will help them to take advantage of the incentives in the act. The government also has outlined what it terms to be meaningful use of electronic health records. The objectives include developing condition-specific patient education resources and providing greater flexibility to eligible professionals in meeting and reporting certain objectives for demonstrating meaningful use (HHS Press Office, 2010). Basically, what the government wants to do is not just ensure that companies invest in electronic health records systems, but that they use these systems for the benefit of the patient. As a result, health care providers must provide evidence and documentation that they are using electronic health records to improve patient outcomes, rather than simply installing the systems and then not using them.

This is why Arlotto proposes such comprehensive strategy to ensure compliance with HITECH. He accurately recognizes that incremental changes are not going to be sufficient to meet the government's standards. The changes, he argues, are intended to be transformational to the health care industry and therefore the industry needs to respond with transformational strategy. He recommends creating a transformational infrastructure. This had led some companies to create a department for transformation, to oversee the different changes that have been brought about in the industry.

Minimum use is a standard by which the government measures the implementation of electronic health records at health care providers. There are two major standards at work (HHS Press Office, 2010). The first is that the minimum requirements for providers are defined, outlining for providers how much technology they need and what they need to use it for. The second element identifies the standards and criteria for the certification of EHR technology (Ibid). These elements create motivation among health care providers to implement at least the minimal effort because that effort is entrenched in law. For the provider, it is also important to know how to certify its efforts, something that will allow them to prove that they are using EHR effectively.

It is valuable and important to have incentives for the implementation. The minimal standards make it easy for health care providers to take the first step towards implementation. The government also provides financial incentives through its Medicare and Medicaid programs that will help to defray the costs of implementation. This should not be necessary -- joining the 21st century should have enough inherent competitive benefits that health care organizations would implement EHR anyway. However, the government has basically been compelled to force the issue. The result of this is that there are specific financial incentives that will reduce the risk and cost associated with the implementation of electronic health records. Health care providers are forced to start the process, but the combination of standards and incentives will compel them to exceed the minimal performance standards.

There is little doubt that the documentation required is excessive, but this documentation also shows that the firm is obeying the law in spirit, and not just to the letter. In that respect, the law is more about public good than economic pragmatism. This is why the incentives exist, because they provide that economic motivation for health care providers that apparently does not exist intrinsically.