The Health Information Technology for Economic and Clinical Health (HITECH) Act, a component of the vast federal stimulus legislation known as the American Recovery and Reinvestment Act of 2009 (ARRA), authorizes roughly $36 billion in outlays over six years for health information technology--an unprecedented investment in the nation's health information infrastructure. Its success will be measured in part by how well it is implemented and the impact it has on improving the quality, safety, and efficiency of care. Unlike almost all other industries that have implemented information technology, health care retains many of the characteristics of a cottage industry. Despite decades of attempted consolidation, a sharp focus on quality and consistency, and a modest investment in health information technology (Health IT), health care practice remains largely unchanged: fragmented, inconsistent, and only intermittently automated. While many hospitals and large medical groups have adopted health IT systems, most of their smaller counterparts have not had the resources, financial incentives, or economies of scale to do so. Although health IT alone will not transform health care, it does have the potential to stimulate changes that will enhance the quality and safety of health services, stabilize or decrease their cost, reduce waste and inefficiency, increase transparency, and transform the health care enterprise into a learning organization with the capacity to self-correct and improve. Experience has shown that this potential is not easily realized. As the Obama Administration has indicated, the ARRA funds allocated to health care--including more than $36 billion in funds directed towards health IT infrastructure and adoption incentives authorized in the HITECH Act--are a down payment on the much larger amount needed to effect meaningful reform of health care in the United States. California--the center of innovation in biotechnology, health IT, and health care delivery--is well positioned to make effective use of the ARRA funds. This issue brief presents an analysis of the Act and recommendations to the Schwarzenegger Administration, the California Legislature, and others on how to prepare for, compete for, and use the state's fair share of the those funds, which could amount to more than $3 billion.
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