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A Role for IT Companies in HIT Transition
By Liz Hyman

HIT deployment is a vital national priority that has the capability to increase the quality and efficiency of healthcare in the United States while reducing the overall long-term costs associated with antiquated record keeping and other applications. From eliminating the need for duplicative medical tests to providing healthcare professionals with instant access to patient information, HIT is a key component of modernizing the nation’s healthcare system.

Several key legislative efforts have established policies seeking to advance the quality of care and overall health of patients throughout the United States. For example, the HITECH Act was signed into law as part of the ARRA. The legislation provides incentives for the early adoption of EHRs, specifically through incentive payments for achieving the meaningful use of EHRs standard. According to the Centers for Medicare & Medicaid Services, meaningful use means providers must show they’re using certified EHR technology in ways that can be measured significantly in quality and quantity.

Early trends indicate that small medical providers have been slow to adopt HIT. According to the Office of the National Coordinator for Health Information Technology (ONC), only 41% of small medical providers will be compliant with digital health record records by 2014. The main inhibitors of adoption fall into the categories of money, time, and disruption. In many cases, small medical providers are concerned about the lack of staff resources they have to dedicate to a HIT system and navigate complex technologies and the impact this could have on their practices.

In general, the HITECH Act and the subsequent strategies spelled out by federal agencies both have a significant focus on the medical provider yet do not mention the role IT solution providers could play in a successful transition. Therefore, the entire burden has been placed on the medical providers themselves without a focus on partnering with IT solution providers.

The IT industry has the ability and expertise to help fill the HIT void among small medical providers. In particular, small IT solution provider companies have the expertise to be a meaningful partner in the transition. But their ability to enter the HIT market on a large scale is hampered by current policies.

A handful of minor changes to existing policy would make great strides toward bringing the expertise of small IT solution providers into the arena to help advance the transition and remove some of the burden from small medical providers.

Existing tax credit programs could be changed to better support the HIT transition. For example, amending the Lifetime Learning Credit and Business Education Tax Deduction would allow individuals and IT solution providers to offset some of the expense of earning appropriate certifications and skills for the HIT marketplace. These initiatives can provide the necessary incentive to defray the costs for business owners while ensuring the workforce is capable of handling the challenge ahead.

Capital support for small IT businesses should be provided by reallocating funds from existing programs designed to assist small businesses, such as the Small Business Lending Fund. A total of $30 billion has been allocated to the Small Business Lending Fund, but applications for only $12 billion have been received. Undistributed funds should be redirected to address the HIT funding needs.

The ONC has used $677 million to fund 62 regional extension centers (RECs) across the nation to offer healthcare providers “outreach education, EHR support (eg, working with vendors, helping choose a certified EHR system), and technical assistance in implementing health IT and using it in a meaningful way to improve care.”

While some RECs are already effectively doing this, it is important to ensure that RECs across the nation are providing uniform services to best reach the goal of a successful EHR transition. RECs should compile a list of local solution providers that are readily available to medical providers. These lists should be neutral and provide a diverse menu of local options to assist with the EHR transition.

Consumer and medical trust in HIT will only come to pass if there is strong respect for, and protection and enforcement of, personal health information. With that said, there are a series of notable provisions that will lay a substantial burden on small IT solution providers that could severely restrict entry and competition in the HIT space.

One example has to do with data breach notification requirements. Today, more than 40 states have data breach notification laws on the books with varying requirements and standards. When the HITECH Act was enacted, the new law specifically allowed states to maintain their individual data notification laws, so long as the state laws did not provide less protection than the HIPAA Privacy Rule. This interplay between state and federal standards can be a source of great confusion to a small business in the HIT space. For example, under the HITECH Act, a data breach notification must be provided within 60 days of a breach, but in states such as Massachusetts, a notice of data breach must be provided within 45 days.

The HITECH Act should be revised to serve not just as the floor but also as the ceiling for data notification requirements. One law that is consistent across the country with an agreed-upon definition of a breach and notification time period, as well as the elimination of private rights of action, could save small- and medium-sized IT solution providers millions of dollars in reduced compliance and legal costs associated with data breach notification requirements. Such an approach would eliminate uncertainty and confusion as to what the obligation of a business would be in the event of a data breach.

To achieve the dual benefits of healthcare optimization and economic growth, HIT should be implemented in a manner that allows medical providers to continue to focus on patient care and not be distracted with complex and expensive new requirements. The IT industry should be a partner in this process in order to provide a seamless HIT transition while removing the burden from medical providers. This partnership will not only allow for more widespread adoption of HIT among small medical providers but will also allow healthcare providers to continue their focus on patients and avoid dedicating staff to new IT systems.

— Liz Hyman is vice president of public advocacy for CompTIA, a nonprofit trade association for the IT industry.