A bit of important health care news today but first some background: When the stimulus bill passed last year, tucked within it was a bill called the HITECH Act. The HITECH Act's goal was ambitious: to lay down the infrastructure for a 21st century health care system by investing heavily in health information technology (HIT) and health information exchange (HIE), i.e. the electronic movement of health records between institutions. Two agencies within the Department of Health and Human Services are in charge of administering the programs to make that happen. One, created by an executive order from George W. Bush a few years ago and brought into permanent existence by HITECH, is the Office of the National Coordinator for HIT. The other is the Centers for Medicare and Medicaid Services, which just got its first permanent head in four years yesterday after Don Berwick was recess appointed to the position. ONC was given about $2 billion to spend and they've used it to develop a series of HIT capacity-building programs. The largest of those program involves them working with states (every state) to start laying down an HIE infrastructure, particularly by putting together the governing bodies, financial engines, legal frameworks, etc that are needed to make a project like this work. The rest of the money is going toward HIT workforce development programs, grants to universities for R&D on specific topics, and money to help certain existing organizations become "regional extension centers" that will assist health care providers in building their own HIT capacity. CMS, on the other hand, has more money to work with but less to do with it. It was directed by the law to make bonus payments to Medicare and Medicaid doctors and hospitals who implement HIT and start exchanging data. The catch, of course, is that you can't just haphazardly throw this money out there through these programs. A hospital that implements a new system of electronic health records but doesn't use them to do anything useful isn't helping anyone, it's just wasting money on a new toy. Thus the legislation requires that payments be made for "meaningful use" of electronic health records. The concept of meaningful use binds all of these programs, it's the end goal of all of them. The exact definition of what "meaningful use" of EHRs is has gone through a review process (a proposed rule came out of HHS in late December, followed by a 2-month comment period where interested parties offered their input on the proposed rule) and today the final rule came out. If you want a quick look at what the rules entail, you can read an overview from the head of ONC. This is an exciting development because that simple phrase--"meaningful use"--is going to be at the center of many of the quality improvement and cost reduction efforts over the next decade and beyond. Cutting down on medical errors, eliminating waste and unnecessary procedures, paying for quality instead of simply quantity are all important to long-term cost containment strategies, all will rely heavily on HIT, and right now we're in the middle of a Renaissance in our health information technology/exchange abilities. So today we have a boring piece of administrative rulemaking news that actually happens to be very exciting.