Table 1.

Recommendations to Stimulate U.S. EHR Adoption

Expand the HIT Research Agenda

1.Increase funding to evaluate the impact of HIT in practice, with a focus on economic outcomes, costs and benefits.

2.Evaluate the utility of “open source” or public domain software for EHR and implementation and maintenance methods for such systems.

Financial Incentives to Stimulate EHR Marketplace

1.Reimbursement reform: Establish financial incentives for the use of EHR in practice.

2.Capital availability: Establish low-interest loans or a grant program to facilitate hardware and software adoption in health care settings.

3.EHR Certification and Accreditation: Establish a process to certify EHR products as having requisite functionality in accordance with accepted standards and an accreditation process for level of use of EHR in practice.

HIT Standard Setting

1.Coordinate existing efforts to specify essential standards for basic EHR functionality, data representation, and messaging.

2.Specify a minimal clinical data set covering a patient's demographics, medications, medical conditions, allergies, advance directives, and selected data pertinent to patient safety and health care quality.

3.Specify minimal functional standards for HIT systems in acute care and inpatient care settings, personal health records, and key functional components such as CPOE.

Enabling Policy

1.Promulgate Medicare Modernization Act relaxations to Social Security Act, Sec. 1877 (Stark).

2.Establish federal policy on clinical data ownership and stewardship.

3.Establish policy framework for Regional Health Care Information Authorities.

4.Establish U.S. national licensure in the health professions.

Educational, Marketing, and Supporting Activities.

1.Establish educational and marketing campaign for the public—“Got EHR?”.

2.Establish educational campaign for health professionals.

3.Establish educational campaign for health care management.

4.Create a National Health Care Information Technology Resource Center.