RWJF: HITECH Act falls short of overall goals

The HITECH Act has helped initiate "significant" progress in the use of health IT, but has fallen short of its goal to create an efficient and effective healthcare system with the advanced use of health IT, according to a Robert Wood Johnson Foundation report.

The report, entitled Health Information Technology in the United States, 2015: Transition to a Post-HITECH World, found both successes and disappointments in HITECH and the Meaningful Use program. These include:

  • While HITECH was a key driver to the adoption of electronic health records, only 1,826 hospitals had successfully attested to Stage 2 of the program in 2014, far fewer than the 4,379 that attested previously to Stage 1. That indicates that providers were facing substantial challenges in meeting the more stringent requirements. Physician participation in the Program has declined in the past year.
  • Health information exchanges (HIEs) were operating in most states and could support the sharing of different kinds of data, but were faced with obstacles, such as the ability to hire and retain staff, disagreement on what "HIE" includes, privacy concerns and problems with financial sustainability.
  • The regional extension centers helped more than 90 percent of providers who asked for help in adopting an EHR, but less than three quarters of those providers could successfully demonstrate Meaningful Use.
  • EHRs created "corporate islands" that could exchange electronic information internally but that otherwise data exchange was "barely better than it was close to a decade ago." This, however, would likely improve due to payment innovations and the emergence of interoperability software architecture that would make data more "liquid and fungible."

The report also addressed big data; the current and past national health IT coordinators were interviewed.

Additionally, the report noted that the lasting impact of HITECH "remains to be seen," although "early signs are promising," and that perhaps it would have benefited from a more holistic approach, rather than a creation of discrete programs that lacked coordination. Moreover, the United States suffers from particular problems that inhibit the adoption of EHRs and health IT, such as competing proprietary health care systems and the lack of a unique patient identifier.

The HITECH Act and Meaningful Use program has been under increased scrutiny as the program progresses. The rule implementing Stage 3 of the program as well as the rule that would soften some of Stage 2 are both under review at the Office of Management and Budget.

To learn more:
- here's the report (.pdf)