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The health information technology funding and policy provisions in the American Recovery and Reinvestment Act are a "game-changer" for the industry, says Robert Kolodner, the national coordinator for health information technology in the Department of Health and Human Services.

"We really have an unprecedented opportunity and are on the brink of making positive changes for health care," he told attendees of a town hall meeting April 6 at the 2009 HIMSS Conference in Chicago.

Still, Kolodner does not anticipate his successor, David Blumenthal, M.D., will make wholesale policy changes when he becomes the national coordinator in late April. There will be some differences in the focus of certain activities with a new administration, he notes. "But this is not a sharp turn in any direction."

HHS faces several deadlines this year to achieve certain milestones in implementing ARRA's I.T. provisions. For instance, the department by April 18 must issue guidance for how to render protected health information unusable if it is breached. Under the new law, an organization does not have to issue notification of any breaches of unusable data.

HHS is required on May 18 to submit to Congress its 2009 operating plan for implementing I.T. provisions. That's also the deadline for the HIT Standards Committee to develop a schedule for assessing recommendations to the HIT Policy Committee.

Interim final rules covering breach notification of personal health records data are due in August, and the 2010 operating plan for health I.T. initiatives is due to Congress in November. By December, HHS must have interim final rules for initial sets of standards to support a national health information network.

And the big rule, defining "meaningful use" of electronic health records, is due sometime this year. Under ARRA, physicians and hospitals must be meaningfully using EHRs that have certain features to improve the quality and efficiency of care to qualify for Medicare and Medicaid incentive payments.

The coming Medicare inpatient prospective payment system and physician fee schedule rules could start to clarify what "meaningful use" means, says David Hunt, M.D., CMO in the office of health I.T. adoption in the national coordinator's office. Or those rules could be "vehicles" for publishing proposed definitions, he says. Another option is the proposed definitions could be published in a separate rule.

The Secretary of Health will decide in what form the rules for meaningful use come out. Whatever the form, the rules, and much more information, will be on a new government health I.T. Web site, http://healthit.hhs.gov.

--Joseph Goedert