HHS spends $228M on IT programs

"HHS's Efforts to Promote Health Information Technology and LegalBarriers to Its Adoption"

A preliminary accounting of efforts by the Department of Health and Human Services shows that the agency has about 19 major health information technology initiatives, totaling about $228 million.

According to a Government Accountability Office report, some of HHS' programs, such as the National Health Information Infrastructure (NHII) and Federal Health Architecture (FEA), are designed to provide overall coordination and leadership across the office's own agencies, other departments, and public- and private-sector groups.

But the majority of such IT initiatives and funding are for health IT programmatic activities and grant programs.

For example, the Agency for Healthcare Research and Quality is funding various programs designed to demonstrate the value of health IT, such as promoting the use of electronic health records. Another example is the Centers for Medicare and Medicaid Services' testing of electronic prescribing standards.

The various programs include the promotion of electronic health records and bar codes on drug products, development of networks for information sharing, research and training for advanced computer technologies and health informatics, pilot tests, development of standards, and interoperability, to name a few. GAO's report focuses mainly on the use of IT for clinical health care delivery, not disease surveillance systems and telemedicine.

Last month, David Brailer, a California physician who became the first national coordinator for health IT, released a 10-year strategic plan to promote the adoption of electronic health records, information exchange and use of personal health records, as well as to develop telehealth systems and improve public health surveillance.

Part of what Brailer's office will do is take inventory of what HHS has been doing with regard to health IT, something that hasn't been accounted for previously.

GAO officials, who responded to a request by Sen. Judd Gregg (R-N.H.), chairman of the Senate Committee on Health, Education, Labor and Pensions, reviewed HHS' major activities in promoting health IT and legal barriers to providers' adoption of health IT.

The report indicates beyond privacy and security that there are various laws — involving fraud and abuse, antitrust, federal income tax, intellectual property, malpractice and state licensing — that present barriers to health IT adoption. Some are specifically health-related and some are not.

"Because the laws frequently do not address health IT arrangements directly, health care providers are uncertain about what would constitute violations of the laws or create a risk of litigation," the report states. "To the extent there are uncertainties and ambiguity in predicting legal consequences, health care providers are reluctant to take action and make significant investments in health IT."