Is HITECH Working?

After only one year, it is too early to assess the true impact of the Health Information Technology for Economic and Clinical Health Act. The first reimbursement payments to physicians for electronic health record adoption won't go out until 2011, after all. But early signs suggest that the program is pushing more physicians to adopt EHR systems, and that it is well on its way to accomplishing its long-term goals.

For example, in the 2010 HealthLeaders Media Industry Survey, we asked physician leaders about their plans for taking advantage of HITECH funds. More than 40% expect they will meet the meaningful use requirements and be eligible to receive reimbursements for EHR use by next year. Although quite a few respondents said it was still too early to tell if they will be eligible down the road, only less than 10% expected to not be eligible at all.

That's good news for an industry that seemed like it would take decades to get fully onboard with EHR use.

The Bush administration initially set the goal of EHRs for every American by 2014, and with an executive order in 2004, Bush created the new position of the National Coordinator for Health Information Technology to oversee the transition. This was a big first step toward improving national adoption, but the recent success seems to boil down to one factor: Money.

The promise of a financial carrot for adoption—as well as the eventual stick of lower Medicare reimbursements—has gotten physicians' attention.

As my colleague Gienna Shaw pointed out in a recent column, money has always been the biggest concern for doctors when it comes to technology. When I first wrote about the HITECH Act last year, most of the feedback I received from physician readers included concerns about costs, as well.

But there are other worries. According to a new survey from the Medical Group Management Association, a majority of practices fear that meaningful use criteria are too complex and will decrease provider productivity. There were two specific requirements that had providers worried:

• The proposed requirement that 80% of all patient requests for an electronic copy of their health information be fulfilled within 48 hours
• The proposed requirement that 10% of all patients be given electronic access to their health information within 96 hours of the information being available

While maintaining productivity is a concern, it is primarily a transitional issue, not a problem that should completely prevent adoption. No one said the transition would be completely painless, but with most of the costs taken care of, practices are in a much better position to solve the operational challenges before 2011.

Interestingly, despite concerns about its implementation, the HITECH Act is one of the most popular components of the Obama administration's efforts to reform healthcare. More than 54% of respondents to the HealthLeaders Media survey have a positive view of it, which is considerably higher than anything else under the reform umbrella.