Obama Taps David Blumenthal, M.D., M.P.P. To Lead Effort To Modernize U.S. Health Information Technology

The Department of Health and Human Services today (March 20, 2009) announced the selection of David Blumenthal, M.D., M.P.P. as the Obama Administration’s choice for the newly created post of National Coordinator for Health Information Technology.  As the National Coordinator, Dr. Blumenthal will lead the effort at the Department of Health & Human Services (HHS) to modernize the health care system and reduce health care costs by catalyzing the federal government’s adoption of interoperable health information technology by 2014.

Health information technology is a critical part of the Obama Administration’s strategy to reform the U.S. health care system. The Obama Administration believes the implementation of interoperable health care records and other appropriate health information technology will reduce health costs for the federal government by an estimated $12 billion over 10 years.   

In pursuit of these perceived savings, the Health Information Technology for Economic and Clinical Health Act (“HITECH Act”) enacted as part of the American Recovery and Reinvestment Act allocates $19.5 billion for investment in health information technology that will save money, improve quality of care for patients, and improve efficiency with the U.S. health care system. 

The HITECH Act seeks to realize this goal by charging the newly created Office of the National Coordinator for Health Information Technology (ONCHIT) with “development of a nationwide health information technology infrastructure that allows for the electronic use and exchange of information that: 

·        Ensures each patient’s health information is secure and protected, in accordance with applicable law;

·        Improves health care quality, reduces medical errors, reduces health disparities, and advances the delivery of patient-centered medical care;

·        Reduces health care costs resulting from inefficiency, medical errors, inappropriate care, duplicative care, and incomplete information;

·        Provides appropriate information to help guide medical decisions at the time and place of care;

·        Ensures the inclusion of meaningful public input in such development of such infrastructure;

·        Improves the coordination of care and information among hospitals, laboratories, physician offices, and other entities through an effective infrastructure for the secure and authorized exchange of health care information;

·        Improves public health activities and facilitates the early identification and rapid response to public health threats and emergencies, including bioterror events and infectious disease outbreaks;

·        Facilitates health and clinical research and health care quality;

·        Promotes early detection, prevention, and management of chronic diseases;

·        Promotes a more effective marketplace, greater competition, greater systems analysis, increased consumer choice, and improved outcomes in health care services; and

·        Improves efforts to reduce health disparities.

 

The HITECH Act requires the National Coordinator: 

·        To review, determine and report its recommendation to the HHS Secretary whether to endorse every standard, implementation specification, and certification criterion for the electronic exchange and use of health information recommended by the HIT Standards Committee within 45 days of receiving the recommendation;

·        To review Federal health information technology investments to ensure that Federal health information technology programs are meeting the objectives of the HIT strategic plan required by the HITECH Act;

·        To coordinate health information technology policy and programs of HHS with those of other relevant executive branch agencies with a goal of avoiding duplication of efforts and of helping to ensure that each agency undertakes health information technology activities primarily within the areas of its greatest expertise and technical capability and in a manner towards a coordinated national goal;

·        To e a leading member in the establishment and operations of the HIT Policy Committee and the HIT Standards Committee and shall serve as a liaison among those two Committees and the Federal Government;

·        To update and republish in print and on the internet the existing Federal Health IT Strategic Plan developed as of June 23 2008,  which is currently posted at http://www.hhs.gov/healthit/resources/HITStrategicPlan.pdf in consultation with the National Institute of Standards and Technology and other appropriate Federal agencies as well as private entities;

·        To maintain and frequently update an Internet website on which there is posted information on the work, schedules, reports, recommendations, and other information to ensure transparency in promotion of a nationwide health information technology infrastructure;

·        By November 17, 2010, to report to Congress any additional funding or authority the Coordinator or the HIT Policy Committee or HIT Standards Committee requires to evaluate and develop standards, implementation specifications, and certification criteria, or to achieve full participation of stakeholders in the adoption of a nationwide health information technology infrastructure that allows for the electronic use and exchange of health information;

·        In consultation with the Director of the National Institute of Standards and Technology, also will keep or recognize a program or programs for the voluntary certification of health information technology as being in compliance with the adopted applicable certification criteria including, as appropriate, testing of the technology in accordance with section 13201(b) of the Health Information Technology for Economic and Clinical Health Act.  For this purpose, the HITECH Act defines “certification criteria” means criteria to establish that the technology meets the adopted standards and implementation specifications for health information technology;

·        To prepare a report that identifies lessons learned from major public and private health care systems in their implementation of health information technology, including information on whether the technologies and practices developed by such systems may be applicable to and usable in whole or in part by other health care providers;

·        To assess and publish the impact of health information technology in communities with health disparities and in areas with a high proportion of individuals who are uninsured, underinsured, and medically underserved individuals (including urban and rural areas) and identify practices to increase the adoption of such technology by health care providers in such communities, and the use of health information technology to reduce and better manage chronic diseases;

·        To evaluate and publish evidence on the benefits and costs of the electronic use and exchange of health information and assess to whom these benefits and costs accrue.

·        To estimate and publish resources required annually to reach the goal of utilization of an electronic health record for each person in the United States by 2014, including the required level of Federal funding; expectations for regional, State, and private investment; the expected contributions by volunteers to activities for the utilization of such records; and the resources needed to establish a health information technology workforce sufficient to support this effort (including education programs in medical informatics and health information management);

·        To establish a governance mechanism for the nationwide health information network; and

·        To provide financial assistance to consumer advocacy groups and not-for-profit entities that work in the public interest for purposes of defraying the cost to such groups and entities to participate under, whether in whole or in part, the National Technology Transfer Act of 1995, 15 U.S.C. 272.

 

The HITECH Act also requires the HHS Secretary to appoint a Chief Privacy Officer of the Office of the National Coordinator by November 17, 2010.  The Chief Privacy Officer will be responsible for advising the National Coordinator on privacy, security, and data stewardship of electronic health information and to coordinate with other Federal agencies (and similar privacy officers in such agencies), with State and regional efforts, and with foreign countries with regard to the privacy, security, and data stewardship of electronic individually identifiable health information.

The existing Federal Health IT Strategic Plan was developed as of June 23 2008, and is posted on the HHS website at http://www.hhs.gov/healthit/resources/HITStrategicPlan.pdf.  The updated strategic plan is required to include measurable outcome goals, including, to include specific objectives, milestones, and metrics with respect to the following:

·        The electronic exchange and use of health information and the enterprise integration of such information.

·        The utilization of an electronic health record for each person in the United States by 2014.

·        The incorporation of privacy and security protections for the electronic exchange of an individual’s individually identifiable health information.

·        Ensuring security methods to ensure appropriate authorization and electronic authentication of health information and specifying technologies or methodologies for rendering health information unusable, unreadable, or indecipherable.

·        Specifying a framework for coordination and flow of recommendations and policies under this subtitle among the Secretary, the National Coordinator, the HIT Policy Committee, the HIT Standards Committee, and other health information exchanges and other relevant entities.

·        Methods to foster the public understanding of health information technology.

·        Strategies to enhance the use of health information technology in improving the quality of health care, reducing medical errors, reducing health disparities, improving public health, increasing prevention and coordination with community resources, and improving the continuity of care among health care settings.

·        Specific plans for ensuring that populations with unique needs, such as children, are appropriately addressed in the technology design, as appropriate, which may include technology that automates enrollment and retention for eligible individuals.

For advice about regulatory and other legal challenges associated with the development and use of interoperable health care records and other emerging health information technologies, and/or assistance monitoring, evaluating and responding to the HITECH Act, contact Cynthia Marcotte Stamer at cstamer@solutionslawyer.net or 469.767.8872.

 

©2009 Cynthia Marcotte Stamer.

 

 

 

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