Earlier this week, President Barack Obama signaled in his State of the Union speech that investment in health information technologies like electronic health records remains a priority for his administration. While the nation's top executive may favor these programs, a new political reality may make it somewhat more difficult to accomplish some of his stated goals.
Support for EHRs and other forms of health IT in Washington is currently a mixed bag. Some agencies have recently moved to make more funds available for investing in technology. However, Republican lawmakers have vowed to cut every bit of discretionary spending that can possibly be eliminated. This may jeopardize some of the key incentive programs designed to spur adoption of EHRs.
For example, Representative Jim Jordan of Ohio, along with 175 other Republican Reps, recently introduced legislation that would reduce non-defense discretionary spending by $2.5 trillion over the course of the next 10 years.
While this bill does not target the American Recovery and Reinvestment Act for repeal, CMIO Magazine reports that it does call for any unallocated funds from the act to be cut.
The EHR incentive program from the Centers for Medicare and Medicaid Services relies on funding from ARRA. Under the 2009 act, $19 billion were provided to the agency to be dispersed as incentive payments to providers that meet the government's meaningful use rules. It is not clear what effect the republic bill would have on funds that have yet to be distributed to providers.
What is clearer is that the bill would strip all funding from the Patient Protection and Affordable Care Act and the Healthcare Education Reconciliation Act, the news source reports. These two laws make up the foundation of the President's healthcare reform efforts, and provide major incentives for providers to use technology to improve efficiency and lower costs.
However, with Democrats in control of both the Senate and the Whitehouse, the bill stands very little chance of becoming law.
At the same time these political battles are being waged, other governmental agencies are working to make funding more available to speed the adoption of EHRs. For example, the Office of the National Coordinator for Health IT recently announced that it has awarded a total of $80 million to support its Regional Extension Centers, state health information exchanges and community college workforce programs.
David Blumenthal, the National Coordinator for Health IT, said that the incentive program from the Centers for Medicare and Medicaid Services is undoubtedly the "star player" in the government's efforts to speed adoption of EHRs. However, he added that smaller programs like the ones receiving funding will play a vital in making sure that the nation is prepared to get the most out of the technology.
Funding Regional Extension Centers will help ensure that practices are ready to meet his office's meaningful use rules and qualify for the incentive program. These centers provide much-needed technical support and advice on the transition to computer-based systems.
Supporting health information exchanges guarantees that doctors, hospitals and pharmacies will all have a common channel through which they can share information. This may improve efficiency and lower costs. Meanwhile, supporting workforce development ensures that there are qualified individuals ready to oversee these complicated systems.
While these programs may support further use of technology, they fall short of institutionalizing the President's stated goals of having a national healthcare system that is entirely reliant on EHRs. While the programs to make this goal happen are currently in place, their future is less certain, given Republican demands to cut the budget. The question of whether or not these programs will survive will likely play out over the course of the next two years.