This past April, six Republican Senators – Alexander, Burr, Coburn, Enzi, Roberts and Thune – released a white paper, titled “REBOOT: Re-Examining the Strategies Needed to Successfully Adopt Health IT ,” that is critical of the implementation of the HITECH Act’s investment in health IT and the Meaningful Use incentive program in particular. In the report, the Senators identify deficiencies related to health IT implementation in five areas: (1) path toward interoperability; (2) costs; (3) oversight; (4) patient privacy; and (5) path to sustainability. Overall, the report urges that taxpayer investments in health IT be leveraged to benefit the public but without unduly burdening health care providers in the process.
CDT submitted a letter  during the open public comment period provided for in the report. Some issues related to health IT implementation, such as achieving interoperability among disparate electronic health record (EHR) systems, have proven frustratingly difficult to resolve. In enacting HITECH, Congress tried to bring about adoption and use of electronic medical records more rapidly than such change would have occurred absent a federal incentive program – and in fact, adoption of health IT has far exceeded expectations. The multi-stakeholder approach to implementing HITECH has followed the balanced approach recommended by the report: providing value to taxpayers by driving meaningful change to benefit patients and improve health outcomes, while at the same time minimizing burden to providers and others in the health care industry. Hitting “pause” (or even “stop”) on this program would frustrate those aims.
The report raises privacy concerns – but without identifying specific issues or suggesting recommendations. CDT urges the Senators to support more robust efforts to ensure compliance with federal privacy and security laws, both through better enforcement and the issuance of more comprehensive guidance.