Editor’s Note: Dr. Carol C. Diamond was invited by the Health Affairs Blog to comment on the opportunities and challenges awaiting the successor to David Blumenthal in the role of National Coordinator for Health Information Technology.
The new National Coordinator for Health Information Technology will take over a vastly different office from the one that David Blumenthal, MD, assumed in March 2009.
Blumenthal faced a challenge comparable to a start-up CEO suddenly infused with large amounts of venture capital for an idea with great potential and long in the making. Of course, in this case the injection of billions of dollars came from the appropriation of taxpayer money under the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009, and with it also came very aggressive implementation deadlines, public scrutiny and congressional oversight.
At a dot-com pace and with vigorous public input, Blumenthal had to build the Office of the National Coordinator (ONC) staff, stand up infrastructure such as regional extension centers, a certification process for “qualified” health IT, create demonstration programs such as the Beacon Communities, and, most importantly, establish ambitious but achievable targets for “meaningful use”—the rules by which new federal financial incentives under HITECH will be paid to doctors and hospitals for using health information technology (IT).
We owe him our gratitude and respect for the steady and inspiring leadership he provided while vital groundwork of government’s health IT efforts was planned and brought to scale. His successor will have very big shoes to fill, but a different and equally important challenge—to preserve “meaningful use” gains by finding ways to make them sustainable in broader health care reforms.
Now that we are in the throes of implementation, the tactical debates are in full force—including debates about where to set the bar on the next stage of meaningful use requirements and about how to balance a sense of urgency with the very real day-to-day challenges providers face in implementing health IT. These debates, although important, should not become our singular focus, causing us to lose sight of the larger opportunity at hand. It’s critical that leaders make sure that HITECH is not narrowly defined as an exercise in adopting technology, measured by the number of pieces of software installed or the number of electronic health records certified. This was never the intention, as made clear by the conceptual framing written into the law requiring that health IT paid for with federal incentives be “meaningfully used.” In many ways, HITECH has been one of the first real large-scale efforts to change the way health care is delivered and paid for in terms of placing value on outcomes that improve health. To be successful, the larger goals of these investments must always be at the forefront and made clear and tangible for patients and providers alike: improving health, saving lives, reducing errors, and increasing the cost-effectiveness of care while encouraging innovation and protecting privacy.
This item first appeared in the Health Affairs Blog on March 25, 2011. Copyright ©2010 Health Affairs by Project HOPE—The People-to-People Health Foundation, Inc.