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Government & policy

US recovery package has $19 billion for health IT

DENVER, Colo. – On February 17, U.S. President Barack Obama (pictured) signed into law a US$787 billion economic stimulus package that includes more than $19 billion for healthcare IT. At the signing ceremony, President Obama said that digitizing U.S. residents’ health records was long overdue and would help eliminate duplication and save billions of dollars.

Of the $19 billion for healthcare IT, about $17 billion will be delivered through the Medicare and Medicaid programs to those who use Electronic Health Records and report quality data to the government. However, those programs are not expected to begin until 2011.

With funding from the stimulus package, the Centers for Medicare and Medicaid Services (CMS) will pay physicians between $44,000 and $64,000 over five years, for deploying and using a certified Electronic Health Record to care for patients. Physicians who have not adopted certified Electronic Health Record systems by 2014 will have their Medicare reimbursements reduced by up to 3 percent beginning in 2015.

James R. Morrow, MD, a physician at North Fulton Family Medicine in Alpharetta, Ga., who was named Physician IT Leader of the Year by the Health Information and Management Systems Society (HIMSS), welcomed news of the new law’s passage. “In one stroke, Congress has all but removed the biggest stumbling block to EHR adoption - cost,” Dr. Morrow said. “It’s time for doctors to stop complaining about the cost of an EHR and take the ball and run with it toward the goal of better medicine with better records and information sharing across the healthcare team.”

The bill also gives the Office of the National Coordinator for Health IT $2 billion to spend on grants, contracts and other steps along the path to a nationwide health information network. It’s a major boost for this agency, which currently operates with an annual budget of $61 million.

Some of the $2 billion will help support regional health information exchanges and similar services. Other funds would go to states, and ONC would establish health IT regional extension centres to help advance health IT.

It also includes health IT money for the Social Security Administration, Indian Health Service, community health centers, medical schools and other institutions.

Ted Epperly, MD, president of the American Academy of Family Physicians, also welcomed the bill. “This is a great harbinger of what’s to come in terms of what the priorities are,” he said.

While the stimulus calls for a system of Medicare and Medicaid bonuses and penalties to encourage health IT adoption, it does not specify how much of the $19 billion in spending would go to physician practices as opposed to hospitals or community health centers.

The bill would charge the National Coordinator for Health Information Technology and a Health IT Standards Committee under the Dept. of Health and Human Services with guiding spending by developing health IT standards to improve healthcare quality, efficiency and consistency.

Privacy and security is a major issue. Deborah C. Peel, MD, founder of the Coalition for Patient Privacy, on Jan. 19 wrote to a bipartisan group of nine House leaders urging them to ensure that medical data shared electronically will only be used to improve patients’ health. “If we fail to ensure privacy and engender trust, Americans will avoid participation, or worse, avoid care altogether and undoubtedly misrepresent their medical histories,” she said.

Overall, the stimulus package reportedly would:
• Provide $2 billion to the Office of the National Coordinator for Health IT, in part to support regional health information exchanges and establish regional extension centers.
• Require ONC to appoint a chief privacy officer;
• Strengthen HIPAA medical privacy rules;
• Establish health IT policy and standards committees as federal advisory committees;
• Require insurers and healthcare providers that participate in Medicare and Medicaid to use health IT systems that comply with national standards;
• Tap the National Institute of Standards and Technology to test health IT standards;
• Restrict the sale of information included in health records;
• Permit state attorneys general to sue individuals to enforce HIPAA medical privacy and security rules; and
• Require vendors of electronic health records to alert individuals and the Federal Trade Commission of data breaches.

The legislation aims to make electronic health records available to all U.S. residents by 2014 but would not require individuals to use EHRs.