HITECH Act, the ACA, and Ambulatory Care

The forward-thinking Health Information Technology for Economic and Clinical Health (HITECH) Act, signed into law in 2009, triggered a fundamental transformation in how the American healthcare industry serves its patients. Then the Patient Protection and Affordable Care Act (ACA), signed into law in 2010, dramatically changed how America experiences its healthcare services. In addition to ensuring that millions of previously uninsured people had access to healthcare insurance (and the consequent healthcare services), it also changed how medical services are delivered and mandated new patient care outcomes. 

An Evolution in American Health Care

Before 2010, most payers in the healthcare system reimbursed physicians on a fee-for-service model. Patients paid for the services provided with no intentional regard to whether those services improved the patient's health. Consequently, despite spending billions of dollars each year on healthcare services, the overall American population's health was not improving.   The ACA took a different approach and introduced significant mandates that have changed how the U.S. healthcare system works: 

• It mandates that improved patient outcomes should be the focus of the healthcare industry. Prescribed treatments and therapies should result in healthier patients.  
• The law prohibits discrimination against patients with pre-existing conditions, and 
• It requires that all Americans have access to affordable healthcare insurance. 

As a result, Americans who had not previously had access to healthcare services could now see a doctor much easier and more affordably.  Simultaneously, the HITECH Act was transforming how healthcare clinics and hospitals managed their patient data. That Act promoted and expanded the incorporation of technology to manage health information, specifically through the use of Electronic Health Records (EHR). It also introduced the concept of "meaningful use:" Meaningful use asserts that patient information should be safely and electronically shared across the patient's medical team to improve the patient's quality of care. The concept clarifies five main priorities that the newly revisioned healthcare system should address:

1. Improving the quality of healthcare services while reducing health disparities;
2. Including patients and their families in managing their health;
3. Improving the coordination of care across a team;
4. Improving public health in general, and
5. Ensuring privacy and security for healthcare information.  

The ACA's burgeoning new patient population triggered a subsequent boom in the number of available ambulatory care clinics - clinics that provide healthcare services that aren't don't require hospitalization. Also called 'outpatient care,' ambulatory patient services are the most common form of healthcare service and are among the ten "Essential Services" identified in the ACA.  That burgeoning new patient population also generated patient information that was now, under HITECH, to be stored in electronic form - EHR's - and could be shared with any medical professional involved in that patient's care. In 2018, the federal Centers for Medicare and Medicaid Services (CMS) re-labeled the 'meaningful use' intention behind records sharing as promoting interoperability. It also encouraged the adoption of application programming interfaces (APIs) to facilitate the digital management of healthcare services and information. In this intervening past decade, software developers have devised thousands of programs dedicated to achieving the ACA and HITECH goals: to use cutting-edge technology to improve both America's health and its healthcare systems.  

Advances in Healthcare Tech Since The HITECH Act

Advances in technology have changed how the world works and lives, and they've had the same global impact on the practice of healthcare services. Software programs that facilitate both clinical and administrative services are now ubiquitous, speeding healthcare services delivery while also providing significantly more comprehensive oversight of patient health. In addition to managing the explosion in EHRs, computing technologies are also giving medical and healthcare professionals substantially more control over their in-house activities and data. Now they can better track their patients' status while safely remaining in compliance with patient privacy regulations. A few notable examples:

• Mobile Health (mHealth) - Mobile applications developed for today's smartphones and tablets, combined with the APIs, has freed patients and their clinicians from wired connections, offering free mobility in the world while still securely sharing healthcare data. Using mobile technology, patients can access their personal data at will, and providers can see how their patients are faring simply by accessing their cell phones.   
• Telemedicine Services - The opportunity to meet virtually with a healthcare provider is now revolutionizing healthcare. It allows for a convenient and safe way to visit a physician, especially during a pandemic. Telemedicine also allows for patients in rural areas physician access who don't otherwise have another way of accessing healthcare. 
• Remote monitoring tools - Technology now facilitates streaming data-sharing from remote devices to clinician EHRs. Electronic devices worn (or sometimes surgically implanted in patients' bodies) automatically send digital readouts to clinic computers. Healthcare personnel can analyze that information without the patient having to appear in person. 

These examples demonstrate just a small slice of the full scope of advances now provided by healthcare information technology (HIT). Medical professionals have embraced them to provide better patient care. These solutions also provide unmatched administrative controls, too. The EHRs are just one element of the overall clinic technological landscape. Clinics must also secure all that patient data, share it safely with professionals in other offices as well as their patients, and report their compliance with federal and industry standards regularly. Further, there are as many business models of healthcare clinics as there are healthcare clinicians, and each separate facility has its own digital records and processes to monitor. Depending on their business model, some clinics are classified as Accountable Care Organizations (ACO), while others might be Managed Services Organizations (MSOs) or Independent Physician Associations (IPAs). Each clinic business model has its own regulations to follow to ensure it provides the value-based care envisioned by the ACA. Not surprisingly, tracking those details, too, is accomplished with advanced healthcare technology. 

The Future Sees More Healthcare Tech

Today's HIT professionals are already developing the technologies that will change healthcare services tomorrow and in the years to come. Sensors, improved instrumentation, and ancillary technologies are already improving both patients' health and their physicians' decision-making capacities. They're also improving the healthcare facility's functioning by tracking nursing care plans, overseeing pharmaceutical management, and virtually connecting integrated care teams to enhance communication and collaboration.  The pairing of the ACA with HITECH has seen exponential growth in healthcare services and healthcare technologies. Those clinics and clinicians who intend to thrive in the future will ensure they invest as much in their healthcare technology as they do in their trained healthcare personnel.  Contact TempDev today at 888.TEMP.DEV to consult with HIT experts and develop a plan to move your practice into the future.