Findings of our annual IT survey show how the federal stimulus law is driving project priorities
The American Recovery and Reinvestment Act of 2009 is known colloquially as the stimulus law. When it comes to stimulating the attention of the healthcare industry, so far the law has lived up to its name. It remains to be seen whether the premier healthcare information technology initiative of the sweeping, year-old stimulus law—its multibillion-dollar electronic health-record subsidy program—will work as planned.
Several key pieces still need to fall into place before Medicare and Medicaid, the programs handling the subsidies, will be ready to funnel an estimated $14 billion to $27 billion in net payments into the purchase and meaningful use of EHRs by hospitals and officebased physicians.
For example, there is only a proposed definition of meaningful use committed to writing. It wasn’t released by the CMS until late last year, and David Blumenthal, head of HHS’ Office of the National Coordinator for Health Information Technology, said at a recent federal IT advisory panel meeting that the CMS rule was “not set in stone.”
Meanwhile, the procedure has not been adopted yet by the ONC for accrediting organizations capable of testing and certifying EHRs as having all the functions necessary to meet meaningful-use criteria. Federal privacy guidelines on how patients can control certain disclosures of their medical records are not yet in place. Further, the ONC just hired Georgetown University researcher Joy Pritts on Feb. 16 to the new, stimulus law-mandated position of chief privacy officer.
Yet, if findings from Modern Healthcare’s annual information technology survey are a fair guide, the stimulus law most certainly has drawn the attention of the provider portion of the healthcare industry.
Meaningful-use, interoperability and qualityreporting requirements, stiffer privacy and security requirements, breach notification standards—all IT areas addressed by the stimulus law—dominated this year’s survey.
For example, meeting meaningful use was mentioned most often among a list of 19 IT priorities to be addressed in the next 24 months, selected by better than two-thirds of survey respondents (See chart showing the top 10, p. 28).
Similarly, meaningful use ranked first among 21 possible “hot button” IT priorities, selected by 58% of survey participants (See related story, p. 32).
The survey results also revealed a fair amount of skepticism and trepidation about stimulus law programs and requirements. A sizable minority, about 31% of respondents, indicated they question whether they’ll be able to comply with the stimulus law’s meaningful-use criteria, particularly during the first stage of the subsidy regime, where the initial criteria for the Medicare portions of the program will be the same for both the 2011 and 2012 payment years. (States, in coordination with the CMS, can set more-stringent meaningful-use criteria for their EHR subsidy programs under Medicaid.)
That minority of respondents answered that they either were unsure, somewhat unlikely or highly unlikely to be able to meet the meaningful-use requirements in time for the initial payments to begin in 2011. The number of skeptics dropped to about 14% of survey respondents for the 2013 and 2015 payment years.
Similarly, while a plurality (46%) of respondents indicated they thought their organizations would benefit from a stimulus law-funded regional IT extension program, 42% were unsure and 12% didn’t believe it would be beneficial.
Healthcare data privacy and security rules that were stiffened and broadened by the stimulus law also emerged as a cause of concern among some survey participants, particularly the heightened responsibilities the new law places on handlers of patient information in the event of a data breach.
Co-dependency in IT
John May, chief financial officer at 41-bed Wetzel County Hospital, New Martinsville, W.Va., may be typical of many survey respondents this year.
“Our biggest challenge is going to be to get compliant with the ARRA,” May says. For now, however, he says, “We’re nowhere near that, and a lot of it is going to depend on our vendor being in compliance.”
“We’ll make it over the total term of this thing, but whether or not we’ll make it in year one, we’re not sure,” May says. “We’re not a