IT plays critical role in health care reform

Health information technology and electronic health records underpin many of the provisions in the comprehensive health reform legislation passed by Congress, especially in improving efficiency,  transparency and quality of care and reducing fraud.

The House passed the Patient Protection and Affordable Care Act  of 2010 on March 21, and it was signed into law by President Obama today. The reform package also includes the Health Care and Education Affordability Reconciliation Act of 2010. The combined measures would provide health insurance for as many as 32 million Americans.

The most significant provisions involving health IT involve quality reporting. The legislation describes new and expanded quality reporting by doctors and hospitals that will be performed electronically. This will involve both electronic records and health information exchange systems and networks. The eventual goal is to collect data on how providers and what treatments are improving outcomes, and to link care payments to those outcomes.

The legislation also envisions a national strategy and priorities for improved quality through reporting with an interagency working group, development of quality measures, data collection and public reporting.

The secretary of Health and Human Services, as part of creating the national strategy, shall ensure that the priorities “enhance the use of health care data to improve quality, efficiency, transparency, and outcomes,” the legislation states.

The quality reporting elements build upon the requirements recently developed by the Health and Human Services Department for the distribution of $17 billion in economic stimulus law funds to providers who buy and meaningfully use electronic record systems. To demonstrate meaningful use, doctors and hospitals must collect and share data about their patients and their care. Initially, for example, the physicians and hospitals must provide such information as what are the body mass indices of their patients, and what percentage of their patients smoke tobacco. In future years, the quality reporting is expected to become more complex and to be linked with payments.

The health care reform bill also has provisions for improving transparency, including collection of information about physician ownership in facilities. It has anti-fraud provisions, including expanded data collection and a larger number of data elements to be reported by Medicaid and Medicare providers.