Saince

The American Recovery and Reinvestment Act (ARRA) of 2009 will provide $19 billion over the next five years to help physicians and hospitals purchase and implement Health Information Technology (HIT). This will surely have a long-lasting effect on the establishment and incorporation of health information management (HIM). A total of $59 billion will be provided in funding for healthcare under ARRA. Community Health Centers, COBRA, Medicaid, Privacy (under HIPAA), Indiana Health Service Facilities, National Institutes of Health (NIH) research and facilities, and training primary care providers will all receive financial aid under ARRA.

Uniform electronic standards will be a key element to the adoption of HIT. These standards will enable different HIT systems to communicate with each other, thus increasing the benefits of HIM for both patients and medical personnel. ARRA requires uniform electronic standards to be adopted by the Department of Health and Human Services (HHS) by Dec. 31, 2009. Within HHS, the Office of the National Coordinator for Health Information Technology (ONCHIT) is responsible for promoting the development of a nationwide interoperable HIT infrastructure. A qualified electronic health records (EHR), or HIT, system will be available to health care providers for a minimal fee through ONCHIT. Physicians do not need to purchase this EHR system, though; they will be free to purchase any one they choose, as long as it meets certain standards and is capable of interoperability. This gives them the freedom to choose the system or brand that their local healthcare organization is using, in order to ensure interoperability.

ARRA has established HIT Policy and Standards Committees, which will provide recommendations on the HIT standards, implementation, and certification criteria for the exchange of electronic health information. The committees will include public and private stakeholders in health care, such as physicians and other medical professionals. ARRA will also encourage, through Medicare, physicians and hospitals to adopt EHR, and through ONCHIT, will authorize grants to states for loans to healthcare providers. Medicaid providers will also receive incentives, but cannot receive incentives under both the Medicare and Medicaid programs.

Early adopters (with a payment year of 2011 or 2012) will be eligible to receive an initial incentive payment of up to $18,000. The payment limit will equal $12,000 in 2014.

According to the American Medical Association (AMA), physicians who do not adopt a certified HIT system will face reductions in their Medicare fee schedule (-1% in 2015, -2% in 2015, and –3% in 2017 and beyond). In 2019, HHS will increase penalties, but they will not exceed –5%. Rural areas without sufficient Internet access are one example of “significant hardship” that would be granted an exception to the penalty.

ARRA will help the medical field work towards the goal of HIT adoption, which many medical professionals would like to see achieved in the very near future. The availability of interoperable EHR standards that are affordable and secure is a very crucial benchmark in this endeavor. Right now many healthcare professionals are using HIT that does not allow them to communicate with others about patient care, and is expensive and still not very secure. The industry cannot afford to be lax with such low regard for patient confidentiality. ARRA is a crucial step to help the medical industry, namely physicians, obtain the financial assistance they need to transition their practices from paper to electronic ones.

The fact that HHS has a deadline of Dec. 31, 2009 to adopt an initial set of HIT standards, implementation specifications, and certification criteria will help speed up the process of adopting HIT.

Physicians who use an EHR system that also has electronic prescribing capabilities would only be eligible for EHR incentives.

HHS IT Security will also receive $50 million under ARRA to help with information technology security.

HIPAA laws will be expanded in order to safeguard patient health information. These fortified HIPAA privacy and security laws would apply directly to business associates of covered entities, according to the AMA (www.ama-assn.org). ARRA authorizes increased financial penalties for HIPAA violations, and grants enforcement authority to state attorneys general to enforce HIPAA.

ARRA define actions that constitute a breach of patient health information and requires notification to patients if their health information is breached. Personal health record vendors will be required to notify individuals of a breach of patient health information. The AMA also notes that uncovered HIPAA entities, such as Regional Health Information Organizations (RHIOs), Health Information Exchanges (HIEs), e-Prescribing Gateways, and Personal Health Record (PHR) vendors, are required to have business associate agreements with covered entities for the electronic exchange of patient health information.