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Study: HITECH Act Boosted EHR Use, Misses Mark with Interoperability

September 22, 2015
by Heather Landi
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Significant policy changes, such as the Health Information Technology for Economic and Clinical Health (HITECH) Act, have advanced the adoption of health information technology (HIT), but, so far, these efforts have missed the overall goal of creating an interoperable healthcare system, according to a recent report from The Robert Wood Johnson Foundation.

The study, entitled Health Information Technology in the United States, 2015: Transition to a Post-HITECH World, was developed by RWJF along with researchers from Mathematica and Harvard School of Public Health and University of Michigan, School of Information.

According to the report, the HITECH Act, which was passed as part of the American Recovery and Reinvestment Act of 2009, helped to initiate significant progress with regard to the adoption and use of HIT in the United States, yet, “in general, it fell short of achieving its overarching goals to establish a highly effective and efficient health care system enabled by the advanced use of HIT.”

The report reviewed the “highlights and milestones of the past eight years,” including the implementation of the HITECH Act, and also projects its future effects on the healthcare industry.

“Overall, the ambitious goals of HITECH, while optimistic, overlooked barriers that were beyond the scope of the legislation and the programs it authorized. As the nation continues on the path to optimize the use of HIT, successes, barriers, and lessons learned through the HITECH cooperative agreement programs will continue to shape these efforts,” the report states.

Among the key findings in the report, researchers found that appropriately three-quarters of hospitals have at least a basic electronic health record (EHR) system, which represents a significant increase from the prior year, and 66 percent of hospitals reported exchanging data with outside health professionals and that percentage has increased since 2008.

However, the report also finds that “fewer hospitals appear to be ready to meet Stage 2 meaningful use criteria and may be subject to penalties.”

With the passage of the HITECH Act in 2009, there was a more concerted federal effort to increase health information exchange (HIE), yet despite this investment, “HIE efforts have persistently struggled with challenges to financial viability and sustainability,” the report states.

“HIE efforts operate in the vast majority of states and should, in theory, be broadly available to health professionals within those states. In addition, HIE efforts appear to  be supporting the exchange of a board range of types of clinical data, with a particular focus on summary of care records, discharge summaries, and test results. In addition, HIE efforts are working to support new models of care and payment, suggesting that HIE efforts are adapting to meet the needs of the changing health care delivery system,” the report states.

However, the survey findings also identified a number of substantial challenges, including “technical, financial, governance, human resources, privacy and security and patient  consent.”

“Moving forward, it will be important to understand whether there is some  prioritization of these barriers and then understand whether there is a set of policy remedies that are feasible,” the report states.

Looking ahead, the study authors forecast that “big data” could transform the healthcare system and argue that payment reform and HIT interoperability must follow the same innovation route to provide “a fluid and meaningful exchange of useful health information data.”

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