HITECH Provisions Likely to be Implemented

The HITECH act, passed in 2009 has many provisions to improve health care outcomes at the behest of technology. Although well meaning, some provisions may be more easily implemented than others. It is well understood that many small, rural, physician practices around the United States lack the vast resources of larger hospitals or academic medical complexes. It is also understood that the majority of Americans utilize these smaller physician practices. The ramifications being that technology, such as implementing a health care information system (HCIS), can be much easier for these larger institutions to implement.

One of the goals of the HITECH act is to have an electronic health record (EHR) for every person in the United States. On the surface this is reasonable but in practice, considering that a large portion of the population sees physicians in the smaller, rural practices. To combat this issue, the HITECH act introduced provisions for physician groups or consortiums, to share such resources as EHR systems, and even has allowed larger hospitals to open up their EHR systems for use by smaller physician practices. Even with these provisions from the HITECH act, it will be very difficult to see every person in the country with an electronic health record.

Technical barriers to health care system implementation could also hinder the HITECH act from realizing its goals. Such barriers encompass how new and emerging technologies integrate with existing systems. Systems must be planned wisely by individuals who understand existing and emerging technologies as well as data definitions and standards. It is the standards and data definitions that allows one system to integrate with another. For example, the standards or data definitions for an EHR vendor must be in synch with those from a CPOE vendor or the systems risk becoming data silos. Poor standards and the rapid advancement of the underlying technology can inhibit the adoption and utilization of a health care information system. The HITECH act has provisions for standard setting utilization of classification and terminology systems, like SNOMED-CT and LOINC, and EHR certification but these appear to be falling short as according to Gartner, interoperability continues to be a great barrier to realizing the full benefits of EHR systems.

Privacy and security is also a major challenge to overcome when implementing a health care information system. In recent years there has been an increase in identity theft and health care fraud. And even more recently there have been cases of ransomware attacking hospitals. The miscreants encrypt the data systems and will only provide the key once a ransom has been paid (New York Times. 2016). Couple this threat with the financial and criminal penalties for protected health information breaches and it is easy to see why IT security and patient privacy becomes a large concern, even a barrier, when implementing a health care information system.

The HITECH act has many, well envisioned goals to improve the health process for americans. It has provisions to help see these goals to fruition including incentive payments, standard setting, and penalties. However, it has been seen that interoperability, security and realizing an EHR for each citizen may be far reaching goals for the provisions provided by the HITECH act.

Gartee, R. (2017). Electronic health records: understanding and using computerized medical records. NY, NY: Pearson.

Wager, K. A., Lee, F. W., Glaser, J. P., & Wager, K. A. (2009). Health care information systems: A practical approach for health care management. San Francisco, CA: Jossey-Bass.

(2016, February 17). Retrieved October 11, 2016, from http://www.nytimes.com/2016/02/18/us/california-hospital-pays-bitcoin-ransom-to-hackers.html