The American Recovery and Reinvestment Act (ARRA) and its important Health Information Technology for Economic and Clinical Growth (HITECH) Act provision were passed into law in February 2009. Commonly referred to as "The Stimulus Bill" or "The Recovery Act," the legislation allocated $787 billion to stimulate the economy, including $147 billion to rescue and reform the nation's ailing healthcare industry. Backed by an allocation of $19 billion, the legislation authorizes the Centers for Medicare & Medicaid Services (CMS) to provide reimbursement incentives for hospitals and eligible providers who take steps to become "meaningful users" of certified electronic health record (EHR) technology to improve care quality and better manage care costs. The incentives are intended to help healthcare providers purchase and implement health information technology (HIT) and EHR systems, and the act also stipulates that penalties will be imposed after 2015 for providers who fail to adopt use of EHRs.
In addition to the CMS EHR incentive payments for "meaningful use" of certified EHRs by providers and hospitals, HITECH provides significant funding of other initiatives designed to work together to provide assistance and technical support, enable coordination and alignment within and among states, establish connectivity to the public health community, and ensure the workforce is properly trained and equipped to be "meaningful users" of EHRs. Combined, these programs build the foundation for every American to benefit from an EHR, as part of a modernized, interconnected, and vastly improved system of care delivery. Here is a brief list on these federally funded programs:
* Regional Extension Centers (RECs). Seventy RECs were funded to offer technical assistance, guidance, and information on best practices to support and accelerate healthcare providers' efforts to support providers in adopting and becoming meaningful users of HIT.
* State Health Information Exchange Cooperative Agreement Program. Fifty-two state-based programs were funded to support states in establishing health information exchange (HIE) capability among healthcare providers and hospitals in their jurisdictions.
* Beacon Community Program. Support of 17 selected communities that have already made inroads in the development of secure, private, and accurate systems of EHR adoption and HIE. These communities are expected to generate lessons learned on how other communities can achieve similar goals enabled by HIT.
* Strategic Health IT Advanced Research Projects Program. Funding of four research programs focused on achieving breakthrough advances to address well-documented problems that have impeded HIT adoption: (1) security, (2) patient-centered cognitive support, (3) healthcare application and network design, and (4) secondary use of EHR data.
* Workforce Training Programs. Support of the following four programs aimed at ensuring a workforce of up to 45 000 new HIT workers to assist providers in becoming meaningful users of EHRs.
(1) Community College Consortia. Eighty-two community colleges funded through five regional consortia to rapidly create HIT educational programs in order to establish intensive, nondegree training that can be completed in 6 months or less.
(2) University-Based Training. Funding to establish nine university-based certificate and advanced degree HIT training programs.
(3) Curriculum Development Centers. Funding of five universities to develop curriculum and instructional materials to enhance the community college workforce training programs.
(4) Competency Examination for Individuals Completing Nondegree Training. Funding to support the development and initial administration of a set of HIT competency examinations.
* Nationwide Health Information Network. Funding to create a common platform for HIE across diverse entities and across the country to promote a more effective marketplace, greater competition, and increased choice through accessibility to accurate information on healthcare costs, quality, and outcomes.
* Standards and Certification. Funding to develop interoperability specifications that identify harmonized standards and provide detailed technical specifications for how those standards need to be used; work with healthcare organizations and standards-development organizations to ensure that standards are available for use nationally.
With this background, we are laying the foundation for a series of articles that will describe, in much greater detail, each of these HITECH programs. The articles will be authored by nurses who are participating in each of the programs, including a description of their role. This issue starts with a description of the Beacon Community Program, by Deborah Aldridge.