Alie Cohen

What is the HITECH Act?

March 18, 2021

The HITECH Act is part of the ARRA of 2009, and was created to promote and expand the adoption of health IT. Here we cover everything you need to know about these acts and how they incentivize the use of EHRs by healthcare providers.

What is the HITECH Act?

Last week, we gave you a quick overview on Federal Policy.

This week, we’re talking about the HITECH Act.

What is the HITECH Act?

Oh you mean the Health Information Technology for Economic and Clinical Health Act? It’s part of The American Recovery and Reinvestment Act of 2009 (ARRA), and it was created to promote and expand the adoption of health information technology—specifically the use of electronic health records (EHRs) by healthcare providers.

Let’s dig into the highlights:

First, the Act defined details around federal HIT policy that had previously been missing. It created ONC as an actual federal agency by law (it had previously been under an executive order), established details around policy and standards and created a committee to keep that policy up to date. Most famously it established the meaningful use program (more about that in a bit.)

In addition, and probably more importantly in the long term for our purposes—the law took a lot of what was established as part of HIPAA and made it more explicit as it relates to electronic health information. It made the HIPAA privacy and security provisions apply not only to the covered entities who had the PHI but also to the Business Associates whose technology is used to manage and access the PHI.

HITECH also detailed how to report security breaches, specifically outlining the applicability to electronic breaches and put more details around what is known as the third party directive, or the right of the patient to tell a provider to send a copy of their information to anyone they designate. Details of how this was to be done and the fact that it should be able to be in any form the patient wanted weren’t put into place until the HIPAA omnibus rule in 2013, but even including it was a win for the patient.

So back to Meaningful Use.

Meaningful Use was defined by the use of certified (by an ONC approved certification body) EHR technology in a meaningful manner (for example electronic prescribing); ensuring that the certified EHR technology connects in a manner that improves the quality of care. By using certified EHR technology, the provider must submit to the Secretary of Health & Human Services (HHS) information on the quality of care and other measures. The concept of meaningful use rested on the five pillars of health outcomes policy priorities, namely:

  1. Improving quality, safety, efficiency, and reducing health disparities
  2. Engage patients and families in their health
  3. Improve care coordination
  4. Improve population and public health
  5. Ensure adequate privacy and security protection for personal health information

Meaningful Use seemed pretty great, but there were a few problems…

  • Lack of standardization: There was no commonly accepted way of identifying patients defined
  • Inconsistency: Data quality within disparate systems was inconsistent at best
  • Onerous enforcement: Implementing health IT interoperability standards across the ecosystem can be very complicated (to say the least)
  • Convoluted process: Reporting requirements included overcomplicated and irrelevant measures
  • Lack of consensus: Stakeholders across the industry have differing and sometimes opposing needs and viewpoints
  • Incompatible design: System design and usability varied greatly depending on the system chosen

In 2018, Meaningful Use was rebranded to Promoting Interoperability Programs. According to CMS the new title better reflects the program’s growing focus on increased accessibility and improved facilitation of data exchange between providers and patients.

A few other things changed, namely, the streamlining of requirements that focus on reducing administrative burdens and... 🥁... 🥁... 🥁... the beginning of a discussion and set of requirements around the use of Application Programming Interfaces by medical record systems to allow better data access.

Do you see where this is all headed? 😎

Keep tuning in as we dive deeper into the four levels of interoperability, the 21st Century Cures Act, TEFCA and much more.