Getting doctors online
One bright light for technology is that the bill sets aside $27 billion to provide incentives of $44,000 to $64,000 for doctors to adopt digital records
"Less than 10 percent of doctors practicing for hospitals have comprehensive digital heath care systems," said Paul Tang, a member of the Health IT Policy Committee that advised the U.S. Department of Health and Human Services on aspects of the bill. "We can't do the reform until the electronic infrastructure is in place," he said.
The bill provides the incentives through 2014 and charges doctor's a small fee starting in 2015 if they still use paper records. It also requires doctor's to show their use of digital records is providing "a meaningful benefit" to patients before they receive the incentives.
"That’s never been done before—we've never been paid based on results," said Tang (below).
Debates have swirled around the government's recently released details that define the term "meaningful use." However Tang defended the recent language which attempts to create thresholds doctors can achieve albeit in a short time.
"By 2017, the U.S. Medicare system goes broke, so the clock we are racing against is 2017," Tang said.
Separately the bill provides about $600 million to help set up a health care exchange network. A separate package in the bill sets aside funds to train health care providers and IT experts on digital health records.
Tang also noted that a "tiger team" is working on how to keep medical records private and secure. "Audit trails [not available for paper records] can actually help with privacy breaches," he said.
"It's quite amazing how comprehensive the program is," he added.