When President Obama signed the American Recovery and Reinvestment Act (ARRA) into law, health IT
was catapulted into a new era. I believe this is — and forever will be — the biggest milestone in the history of health IT. I’d like to share my perspectives on it, but it will take several blog posts to cover such a big topic. Today, I’ll start with a high level view of the significance of this event, and talk about some of the confusion that has resulted from the injection of so much new money – and with it, some new politics – into the world of health IT. Then I’ll follow up with posts that delve into the details of how I believe CCHIT will need to evolve in this new environment.
I’m personally struck by the parallels to a historical event still vivid in my memory: Project Apollo, President Kennedy’s incredible national goal of achieving manned spaceflight to the moon.
Apollo cost $22B (in 1969 dollars, now worth five times that) and took 8 years to achieve the first moonwalk. NASA, a new government agency, spearheaded the effort, but the technology was developed by private sector contractors.
The health IT provisions of ARRA invest at least $35B to incentivize full EHR deployment, allowing 5-7 years to reach that goal – remarkably similar to Project Apollo. The Office of the National Coordinator (ONC) has been codified and funded to lead the effort, and just as in the case of Apollo, I expect much of the work will need to be accomplished by contractors in the private sector — CCHIT included, of course, provided we quickly “grow up” to meet the enlarged responsibilities.
But here’s the key difference: for Apollo, the critical challenge was in the development of new technologies. The only people who had to “adopt” the new technologies were the astronauts. In contrast, although ARRA requires some degree of advancement in technologies, its real challenge lies in changing the behaviors of hundreds of thousands of individuals, and thousands of organizations, across the health care industry. Audible “gulp” here.
This takes something money can’t buy: inspiring, consistent, trustworthy leadership. We need that leadership right now, but we are in the midst of a major political transition. We have a bold new President and landmark legislation, but very limited information on how it will be implemented. Whenever there is incomplete information, rumors and speculation circulate to fill the void. But I’m confident the noise will dissipate as fresh, accurate information begins to flow. And my goal in the blog entries that follow will be to provide what factual information is available, and to offer my own opinions that are clearly identified as such.