Customers in the medical arena keep asking me about federal funding for electronic medical records adoption.  It's true, The American Recovery and Reinvestment Act (ARRA) funding allots a vast amount of money for healthcare IT, as shown below.

§  $2 billion for the Office of the National Coordinator (ONC)

§  $20.819 billion in incentives through the Medicare and Medicaid reimbursement systems to assist providers in adopting EHRs

§  $4.7 billion for the National Telecommunications and Information Administration’s Broadband Technology Opportunities Program

§  $2.5 billion for the U.S. Department of Agriculture’s Distance Learning, Telemedicine, and Broadband Program

§  $1.5 billion for construction, renovation, and equipment for health centers through the Health Resources and Services Administration

§  $1.1 billion for comparative effectiveness research within the Agency for Healthcare Research and Quality (AHRQ), National Institutes of Health (NIH), and the Department of Health and Human Services (HHS).

§  $85 million for health IT, including telehealth services, within the Indian Health Service

§  $500 million for the Social Security Administration

§  $50 million for information technology within the Veterans Benefits Administration

The ARRA earmarks $20.819 billion for direct funding and incentives for providers who implement electronic medical records, sometimes referred to as electronic health records, (EMR/EHR) and use them in a meaningful way. The processes for enacting the provisions of the ARRA and Health Information Technology for Economic and Clinical Health (HITECH) Act, which outlines mandates for IT healthcare spending, are still evolving. 

Physicians, hospitals and other healthcare providers are being asked to pay upfront for software, install it and then prove they can use it in a meaningful fashion before they can collect funding.  The act calls this "Meaningful Use".

The Office of the National Coordinator for Healthcare Technology (ONC) is in charge of issuing guidelines on meaningful use, which may not be available until the end of August 2010.  On May 18, 2009 ONC published a document that provides a road map for their decision making. The document does not provide a firm date for establishing the definition. The document states:

Define “Meaningful use of an EHR”: The Recovery Act authorizes that incentive payments may be made to eligible professionals and hospitals that are using EHRs in a meaningful way. Specific understanding of what constitutes meaningful use will be determined through a process that will include broad stakeholder input and discussion. HHS is developing milestones for major phases of the program’s activities with planned delivery dates.

Who really knows what all of this means?  Many customers are stuck in the middle, needing to adopt some sort of electronic medical record, but are stymied because they do not know what will be eligible for governement funding. 

I think it is very likely the meaningful use definition will start very broadly and include more and more functionality and features of electronic health records over time.  This makes it more difficult to choose a emr/ehr package.  There is no way to know if the package you buy today will meet the meaningful use definition later, or if it will be grandfathered in.  Meanwhile, you might consider starting to digitize your backlog of records.  I will do my best to keep you informed of developments in this arena.

Scott Hambrick