When President Barack Obama signed the $787 billion American Recovery and Reinvestment Act into law, designating approximately $18 billion for the state Medicare programs and $2 billion for healthcare IT investments, providers were left "scratching their heads" about how the funds could potentially impact their bottom line, according to Bradley Erickson, MD, PhD, from the Mayo Clinic in Rochester, Minn.
"It seems that much of this $2 billion will be available through competitive grants which could present opportunities for innovative projects," said Erickson, who is a professor of radiology and informatics at Mayo and current president of Society for Imaging Informatics in Medicine (SIIM).
"In addition to the funds directed at healthcare IT, there are other sources of money that have become available through organizations such as the NIH [National Institutes for Health] and NIBIB [National Institute of Biomedical Imaging and Bioengineering], which have recently stimulus funds outside of the $20 billion," he said. "There is some interest on the part of these organizations, particularly NIBIB, to advance healthcare IT."
After examining the stimulus bill and various reviews of the bill, Erickson noted that the first challenge is timing, especially in regards to the lawmakers rush to prove its effectiveness. "With the main impetus to convert providers into paperless institutions, and the emphasis on proving this bill as stimulative, there is a timing discrepancy with regards to properly planning and implementing the IT systems necessary to transition from paper to electronic setting," he explained. "It's not necessarily realistic for an institution that never planned to convert to electronic records to suddenly change course due to the stimulus package, and perform a complete conversion in a short period of time."
On the other end of the spectrum, there are institutions, like Mayo, which have well-established electronic environments, and yet, could benefit from IT investments, Erickson says. "For example, we have a number of fully planned projects that were shelved due to the economic downturn of the past year. We hope to apply for grants to fund those projects, and we know exactly how many jobs this will translate into with those dollars. We are not unique; a large number of institutions are in similar situations."
These providers, which already use EMRs, may not be "catching all the press," he noted. However, these types of providers, like Mayo, are dusting off healthcare IT projects that have been deferred, and drafting up grant applications to justify their worth. "Mayo and similar institutions are currently prioritizing the importance of each project, evaluating how many jobs they would equate to, assessing the healthcare quality impact and totaling costs to prepare a complete package, in anticipation of a government request for grant applications," he said.
Erickson said that he believes the biggest incentive will be tied to quality. "Increasingly, it is becoming clear that the use of healthcare IT systems makes documenting certain quality metrics easier to do," he said. "Electronic systems facilitate the measurement of important quality parameters. These stimulus monies can document the current state of quality and provide a metric for future improvements."
Another part of the stimulus package is to develop and promote healthcare standards, though Erickson pointed out that the same timing questions apply to this broad topic.
"For example in imaging informatics, a major headache has been the transfer of imaging studies across institutions. As a result, there will be a focus on how to avoid a duplication of studies and the increased exposure to radiation, which occurs when a repeat CT scan is required because one hospital does not have access to the other hospital's images," Erickson explained. "This will be an important focus of the stimulus package, and this is where imaging informatics will see the greatest impact."
He added that sharing information will only become more feasible when vendors adopt similar standards. "Having vendors adopt standards is critical to being able to compare quality across institutions. If that becomes a reality, the parts of the stimulus that incentivize meeting and exceeding certain quality metrics can become more clear and attainable for the providers."