Dr. Farzad Mostashari, who serves as national coordinator for health information technology within the Office of the National Coordinator for Health Information Technology at the Department of Health and Human Services, speaks at the Brookings Institute in Washington on May 17. (J.Lee / Staff)
The Health and Human Services Department has doled out $1.7 billion in stimulus money to build programs to spur the adoption of electronic health records.
• More than 2,000 graduates in April completed six-month community college training for health information technology professionals and are seeking jobs.
• Regional extension centers are working with 67,000 primary care providers to become certified as "meaningful users" of health IT.
• More than $83 million in Medicaid incentive payments have been issued to eligible providers and hospitals to encourage them to adopt health IT for their Medicaid accounts, and the first Medicare payments were disbursed last week.
• Thirty percent of primary care physicians nationwide were using electronic health records in 2010, up from 20 percent a year earlier.
"We are now in the peak and vigor of our youthful adulthood, and we are focused very much on the task at hand," said Dr. Farzad Mostashari, who took the reins as national coordinator for health information technology last month. "The basic framework is very robust, and we're going to continue to move ahead."
The stakes are high, Mostashari said in an interview: "Too many patients are being harmed today by the lack of information." There are too many costs, redundant tests and procedures, and readmissions to the hospital that could be prevented with health IT, he said.
He is optimistic that an interoperable framework will be available within five years for agencies, providers and patients nationwide to share health information electronically across the Internet.
On a smaller scale, several participants — including the Social Security Administration, the National Cancer Institute and Kaiser Permanente — have demonstrated secure health information exchange that will eventually be expanded to connect more networks and more users.
Federal advisory committees are still developing privacy and security protections for information exchange. There must be policies for record locator services that indicate where patient information is stored and requirements for "meaningful choice," or patients' consent for their information to be cataloged and accessed.
Health information exchanges are still being developed at the state level.
North Carolina's Department of State Treasurer, for example, was one of 56 entities that received federal funding to expand health information sharing within and across states.
By the end of the year, North Carolina will have a secure IT system in place for providers, hospitals and others to share information using the state's information exchange, said Dr. Steve Cline, the state health IT coordinator.
The system must be able to verify authorized users so patients can ensure their health information isn't being shared blindly across the state. But some providers and organizations are voluntarily sharing information.
Cline said providers may not be able to deliver lab results on the first day, but the hardware and software needed to support such transactions will be in place.
"We're shooting for that goal, and I believe we will make a lot of progress," Cline said in response to Mostashari's time frame for a nationwide network.
Kaiser Permanente is nearing the launch of a nationwide information exchange, giving its 9 million members an opportunity to have their medical records shared over the Internet with public- and private-sector partners, said Jamie Ferguson, vice president of strategy and policy. Kaiser's membership includes about 500,000 veterans, who receive care at Kaiser facilities and Veterans Affairs Department hospitals.
The software that allows providers to view and extract medical record data uses the standards and specifications set by HHS. The data is encrypted, and patients have to give their consent before their health information is shared, Ferguson said. "It's really about patient treatment, patient care and patient safety."