Blumenthal Delivers a Rousing Farewell at HIMSS

In a deeply felt address to the health care IT community gathered at the HIMSS conference in Orlando, Florida, on February 23, outgoing National Coordinator for Health Information Technology David Blumenthal, MD, told attendees that just two years after the passage of the HITECH Act, health care providers in America have entered the age of meaningful use of health care IT. “I believe we now have it within our grasp, within our collective ability, to transform health care using health IT in a way that would have been inconceivable just a few years ago,” he says. “And I think one key to this is meaningful use.” Blumenthal used the 20-minute talk to review the accomplishments of the HITECH Act to date and to exhort the audience to fulfill the promise of the age of meaningful use, which he described as having three elements. The first—and best understood—is incentives; the second is national infrastructure; and the third is a blueprint for the information providers should be able to summon (as well as how they should be able to use it) to improve the health of patients and the health of the population.Incentives and InfrastructureBlumenthal revealed that 21,300 providers had registered their intent to become meaningful users in the Medicare/Medicaid program at the outset of 2011. Medicaid had paid over $20 million to 25 providers, including hospitals, physicians, and nurse practitioners, and beginning in May, the Medicare program also will begin making payments. “One of the most important and rewarding elements of the incentive program, is the way it seems to be attracting innovation and entrepreneurship within the health IT community,” he says. “That may indeed be its most enduring legacy.” In describing the infrastructure that has been put into place to support health care providers in the demonstration of meaningful use, Blumenthal said: “No country has ever tried to create an equivalent capability to support the transformation of a health information system.” Blumenthal noted that one year ago, the regional extension center program was an idea. It now consists of 62 programs designed to help providers become meaningful users of EHRs. “We are enrolling 6,000 providers a week or more and well on our way to supporting 100,000 providers in becoming meaningful users over the next several years,” he reported. Education programs in 84 community colleges will graduate approximately 300 to 400 trainees this spring to provide much-needed health IT support for vendors and providers for health information exchange; the vision is to train 10,000 health information technology professionals annually. A year ago only a handful of states had health IT experts whose job it was to make sure health information exchange and adoption occurred within their jurisdiction. Currently, every state has a health IT coordinator and 35 states have approved implementation plans for HIE. “HIE is a team sport that happens locally and needs local coaches," said Blumenthal. "The federal government is far too far away to provide that kind of catalytic leadership. We believe the states are part of that solution.”Standards and CertificationBlumenthal recognized Secretary of Health and Human Services Kathleen Sibelius for adopting a set of standards to establish a common platform that would underpin a diverse health IT community of products. “Those standards and certification entities will evolve, especially in the area of interoperability,” he said. “They will move along with the state of MU.” Currently, there are six certification bodies and 415 certified EHRs and EHR modules, two thirds of which are being produced by companies with fewer than 50 employees. Blumenthal called this a sign of the ability of the program to steer innovation. He said that the federal government will continue to offer a variety of tools to make interoperability work, including investment in the nationwide health information network and RHIos. The Third ElementBlumenthal confessed to being most excited about the third element of meaningful use. “If you believe as I do that in a relatively short time, most health information will be stored electronically, then meaningful use provides us with a way to set expectations and goals for what information should be made available, to whom, and for what uses, to support an improved health care system and improved health for Americans.,” he said. This third element of meaningful use is what Blumenthal called a mechanism for all of us, collectively, as citizens, professionals, and patients to answer the following questions:

What health care information should every professional have at a minimum when they see a patient? What capabilities should every institution have to manage and use that information: for instance, the ability to exchange information, the ability to coordinate care, and the ability to subject them to decision support? What information should be available to consumers and patients so they can take a bigger role in their care? What information should government and institutions be able to collect and report to the public, the government, and to health care professionals to hold them accountable for the quality and efficiency of care they provide?

If this nation is to achieve the transformation of the health care system, health care IT professionals must assume a pivotal role, Blumenthal said. “The health IT community should not operate at the margins of the health care system, it has to be at the vital center,” he stated. In conclusion, Blumenthal left the audience with a call to action. “It is a time of almost limitless promise and it has been my privilege to be with you at its inception.”