"Interoperability may not have gotten enough attention in the early days of Meaningful Use's electronic health records (EHR) gold rush, but it's now taking center stage as healthcare providers, government agencies, vendors, and committees consider how to support the exchange of data easily and securely." ~ Information Week Senior Editor, Writer, Alison Diana
What is the HITECH Act?
The HITECH Act, is likely to be a highly popular topic in the next year for every member of the healthcare community. That includes you, whether you're a healthcare professional or provider working to save lives or on the opposite end, as a caretaker or patient relying on their expertise. Regardless of where you reside in the healthcare community, you need to be informed about HITECH in order to be prepared in your unique role.
HITECH Act History:
HITECH is an acronym for Health Information Technology for Economic and Clinical Health. As part of the American Recovery and Reinvestment Act, a.k.a. ARRA, the HITECH Act was signed into law in February 2009.
"The American Recovery and Reinvestment Act that I will sign today - a plan that meets the principles I laid out in January - is the most sweeping economic recovery package in our history," U.S. President, Barack Obama stated. he is referring to the act also known as the A.R.R.A., which includes the HITECH Act and is relevant for healthcare providers, professionals, and patients, today.
HITECH Act Summary:
The goal of the HITECH Act is to improve the manner in which healthcare is delivered and patients are served by investing in progressive health information technologies. Of particular significance is the meaningful use of electronic health records, called EHR's for patients. That is, a digital version of a patient's medical history, such as demographics, conditions, diagnoses, prescriptions, and overall health information. The task of administering the HITECH Act is led by the Office of the National Coordinator (i.e. ONC). That's an important group to remember because they have been granted the ability to offer incentives (e.g. financial, social, etc.) to encourage more people to use EHR's (i.e. electronic health records) throughout the healthcare industry. Check out the info-graphic for a recap of the facts:
HITECH Implications for Patients:
"Under existing law, patients now have a legal right to see and get a copy of their health information from doctors, hospitals and other healthcare providers such as pharmacies and nursing homes, as well as from their health plan," (HealthIT).
HITECH Implications for Providers:
"The federal government provides financial incentives to help healthcare providers offset the initial costs of converting to Electronic Health Records (i.e. EHR's). In exchange, those providers must demonstrate meaningful use of these EHR's," (HITECH Act).
HITECH Act Compliance in the New Year
The adoption of electronic health records is a major part of the HITECH Act. And the section of the law regarding adoption of this technology is divided into three stages. The point of this is to provide a step-by-step guide for the healthcare industry on how to build and use great EHR's, rather than leaving the industry to manage the process without a clear strategy. Each stage pushes the industry a bit more towards better technology and better service for patients. The third and final stage is scheduled to wrap up during the 2017-2018 year, at which point everyone should be in compliance with the HITECH Act and the law. In the end EHR technology should start to show some clear benefits for everyone, including you. According to the Centers for Medicare and Medicaid Services (i.e. CMS) meaningful EHR technology should have the following specific benefits:
Compliance & Meaningful Use of EHR Tech Should Result In:
- Empowered individuals
- Better clinical outcomes
- Increased transparency and efficiency
- Improved population health outcomes
- More robust research data on health systems
Review: What Will Compliance w/ HITECH Mean for You?
A Roadmap to Better Healthcare in 3 Stages
So, what are the three stages of HITECH? What exactly does each stage demand of the industry and what does this mean for patients?
According to Centers for Medicare & Medicaid Services, "Stage 1 set the foundation for the Medicare and Medicaid EHR Incentive Programs by establishing requirements for the electronic capture of clinical data, including providing patients with electronic copies of health information". So, they laid down the standards for EHR's to ensure that they would be truly useful for patients and providers. Then in Stage 2 they, "Expanded upon the Stage 1 criteria with a focus on ensuring that the meaningful use of EHR's supported the aims and priorities of the National Quality Strategy," (CMS). So, stage 2 was designed to encourage us to really use our new tech tools for the easy exchange of information and to continually improve the quality of our patient care in a manner and format that was as well structured as possible. In short, it was meant to improve doctor's abilities to save lives and patient's access to quality care.
- Recap: The 1st part of the HITECH Act was all about preparation - outlining standards for new tech for doctors and healthcare providers. The 2nd part expanded upon this and focused on making sure the tech didn't just work, but could make healthcare services better for actual patients, nationwide.
None of this is possible in the digital future without uncomplicated access to the right information, which is why digital records and systems were given such great weight in the first two stages. So, what's left to do in stage three?
Information regarding stage 3 can be found at the Office of the Federal Register, the daily journal provided by the government for all citizens. The overall focus is to build an "interoperable nationwide health information infrastructure" that also helps to minimize work for IT developer and providers in healthcare. It "Continues to encourage the electronic submission of clinical quality measure data, establishes requirements to transition the program to a single stage, and aligns reporting for providers in the Medicare and Medicaid EHR Incentive Programs". That said, if you'd like a more detailed list of what that entails scroll to the bottom for the 9 key points listed by the Dept. of Health and Human Services and the ONC (PDF):
- Recap: The 3rd part of the HITECH Act is all about interoperability. That means, getting the healthcare industry to the point where everyone is able to share info. (e.g. patient records) digitally and work together to treat patients. Doctor's ability to quickly, share and view updated patient records are a huge part of this.
Stages 1 - 3 in Greater Detail (HealthIT):
- Stage 1: Data capturing and sharing
- Begin the reporting of clinical quality measures and public health information
- Electronically capture health info. in a standardized format
- Use info. to engage patients and their families in their care
- Communicate that info. for care coordination processes
- Use that info. to track key clinical conditions
- Stage 2: Advance clinical processes
- Electronically transmit patient care summaries across multiple settings
- Increase requirements for e-prescribing and incorporating lab results
- More rigorous health information exchange
- More patient-controlled data
- Stage 3: Improved outcomes
- Access to comprehensive patient data through patient-centered health info. exchange
- Improve quality, safety, and efficiency, leading to improved health outcomes
- Decision support for national high priority conditions
- Patient access to self-management tools
- Improve population health
Stage 3 Key Points More Details:
- Improve interoperability for specific purposes by adopting new and updated vocabulary and content standards for the structured recording and exchange of health information, including a Common Clinical Data Set composed primarily of data expressed using adopted standards; and rigorously testing an identified content exchange standard (Consolidated Clinical Document Architecture or C–CDA)
- Facilitate the accessibility and exchange of data by including enhanced data export, transitions of care, and application programming interface or API capabilities in the 2015 Edition Base Electronic Health Record definition
- Establish a framework that makes the Office of the National Coordinator for Health Information Technology or ONC Health IT Certification Program open and accessible to more types of health IT, health IT that supports a variety of care and practice settings, various HHS programs, and public and private interests
- Support the Centers for Medicare and Medicaid Services' EHR Incentive Programs through the adoption of a set of certification criteria that align with proposals for Stage 3;Address health disparities by providing certification: to standards for more granular capture of race and ethnicity; the collection of sexual orientation, gender identity, social, psychological, and behavioral data; for the exchange of sensitive health information (Data Segmentation for Privacy); and for the accessibility of health IT
- Ensure all health IT presented for certification possess the relevant privacy and security capabilities
- Improve patient safety by: applying enhanced user-centered design principles to health IT, enhancing patient matching, requiring health IT to be capable of exchanging relevant patient information (e.g., Unique Device Identifiers), improving the surveillance of certified health IT, and making more information about certified products publicly available and accessible
- Increase the reliability and transparency of certified health IT through surveillance and disclosure requirements
- And provide health IT developers with more flexibility, opportunities, and time for development and certification of health IT that supports interoperability, usability, and innovation