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Health Information Technology

What is it?
Health information technology (health IT, or HIT) is a term that encompasses a number of emerging technologies that make it possible for health care providers to manage patient care, records, and information through computerized or technological systems. Health IT is an emerging field of exchange between providers and patients, and also practices, insurance, government and quality entities. It is increasingly viewed by many as a tool to better manage patient care through secure use and sharing of health information, and for promotion of quality, efficiency, and safety of health care delivery.

Health IT includes such technologies as the use of electronic health records (EHRs) instead of paper medical records to maintain people's health information, or even the idea of universal health records (UHRs). Health IT also encompasses electronic prescribing (E-prescribing, or eRx). It can also refer to electronic personal health records (EPHRs) of either a device or web-based nature. Patient portals on hospital or practice websites are also considered a form Health IT.

Use of Health IT may provide advantages to providers such as access to accurate and complete information about a patient's health, the ability to better coordinate care, especially in the case of serious or complex medical conditions, and information to help doctors diagnose health problems sooner, reduce medical errors, and provide safer care at lower costs. Patients may reap benefits such as secure sharing of medical information, such as test results, through technology, for those who opt for this convenience. Health IT may allow patients to more fully take part in decisions about their health care. It may also expand access to care through such innovations as telemedicine.

Widespread use of health IT may also improve our national health care system through increased efficiency, reduction of redundancy in care and diagnosis, and reduction of paperwork for patients and doctors.

Privacy and Security
One of the biggest concerns with the advent of new technological record keeping and electronic health information is patient privacy and health information security. The Office of the National Coordinator for Health Information Technology (ONC) at the Department of Health and Human Services (HHS) has been tasked with working to ensure that electronic health information exchange is private and secure. Currently, ONC has ongoing privacy and security initiatives covering many different aspects of emerging Health IT.

On July 8, 2010, HHS announced proposed regulations under the Health Insurance Portability and Accountability Act (HIPAA) of 1996 that would expand individuals’ rights to access their information and restrict certain disclosures of protected health information to health plans, extend the applicability of certain of the Privacy and Security Rules’ requirements to the business associates of covered entities, establish new limitations on the use and disclosure of protected health information for marketing and fundraising purposes, and prohibit the sale of protected health information without patient authorization.

ONC is also coordinating with the Centers for Medicare & Medicaid Services (CMS) on CMS’s development of a final regulation on the Medicare and Medicaid Electronic Health Record Incentives Programs. The incentives programs promote critical privacy and security measures and business practices.

ONC also is developing a final regulation on standards and certification criteria to ensure that electronic health records (EHRs) contain the capabilities to support needed privacy and security requirements.

ONC is ensuring that the technical and policy foundations of the nationwide health information network will demonstrate methods for achieving trust among entities exchanging information while integrating best practices for privacy and security. A privacy and security workgroup of the Health Information Technology Policy Committee (HITPC) was convened with strong consumer representation to hold public deliberations and make recommendations related to patient choice in how health information is exchanged; consumer access to health information; personal health records (PHRs); segmentation of health information; and transparency about information sharing and protections.

Health Information Technology for Economic and Clinical Health (HITECH)
The Health Information Technology for Economic Health Act (HITECH), passed as part of the American Recovery and Reinvestment Act (ARRA) in 2009, made important changes to the federal government’s promotion and support of health IT. HITECH provided funding for the Office of National Coordinator for Health Information Technology (ONC) at of the Office of National Coordinator (ONC) Initiatives include:

* Health Information Exchange Program: (all 50 states and eligible territories): The objective of this program is to rapidly build capacity for exchanging health information across the health care system, both within and across states addressing clinical and administrative health care data among health care institutions, providers, and data repositories.

* National Health Information Network: NHIN reflects ONC’s effort to develop the technical specifications and components necessary for a secure national, interoperable HIT infrastructure— standards, services, and policies that enable secure health information exchange over the Internet. NHIN will provide a foundation for the exchange of health information across diverse entities, within communities, and across the country.

* Regional Extension Center (REC) Program: HITECH allocated funding for RECs which will provide health care providers (particularly primary care clinicians) working to adopt and use EHRs with training and support services, information, and guidance.

* Beacon Communities: ONC provides funding to 17 selected communities throughout the United States that had substantial development of secure, private, and accurate systems of EHR adoption and health information exchange. The Beacon Program supports these communities’ efforts to build and strengthen their HIT infrastructure and exchange capabilities to improve care coordination, increase the quality of care, and slow the growth of health care spending. The Program—a proof-of-concept approach intended to demonstrate the ability of HIT to transform local health care systems—focuses measurable improvement in three areas: quality, cost-efficiency, and population health.

What does this mean for my practice?
HITECH also provided for Medicare and Medicaid incentive payments to eligible providers and hospitals to become users of certain Health IT advances, such as electronic health records (EHR) and e-prescriptions (eRx).

Incentives are available for use of some of these technologies, starting in 2011. Some of the incentives will be reduced after 2012. Others, will transform into penalties for non-adoption.

Please see the AAHIVM website page on e-prescriptions (eRx).

Additional Resources

Office of the National Coordinator

ONC- HIT & Privacy and Security


HHS: Health Information Technology

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