Assessing HITECH Implementation and Lessons: 5 Years Later.

Area of Science:

• Health Informatics
• Health Policy
• Health Services Research

Background:

• The Health Information Technology for Economic and Clinical Health (HITECH) Act aimed to reform healthcare delivery and improve outcomes through electronic health information.
• This review assesses the HITECH Act's first five years, examining its implementation, challenges, and lessons learned following the exhaustion of grant funding.

Purpose of the Study:

• To evaluate the accomplishments and shortcomings of the HITECH Act in establishing health information technology infrastructure.
• To identify key challenges and lessons learned from the implementation of HITECH's programs.

Main Methods:

• A global assessment framework was used to analyze the HITECH Act's logic and interdependencies.
• Quantitative and qualitative evidence from program evaluations funded by the Office of the National Coordinator for Health Information Technology (ONC) were incorporated.

Main Results:

• Electronic health records (EHRs) are now prevalent in eligible practices and hospitals, with increased electronic information sharing.
• Progress in meaningful use has been limited, and EHR functionalities vary, impacting patient engagement and care management.
• Significant barriers to interoperability persist, hindering seamless electronic communication across diverse healthcare settings.

Conclusions:

• The HITECH Act's ambitious goals necessitated complex infrastructure and relationship development, revealing points of vulnerability.
• Adoption of EHRs was more readily achieved than the development of a robust infrastructure for effective data use and sharing.
• Sustained support and adaptability to state/local policies and market dynamics are crucial for future health IT success in improving care and reducing costs.