A Patient-Centric View of ARRA: Title XIII-Health Information Technology: Part I

My approach to regulations and legislation in health care is to enjoy and savor them by reading the actual text. For me, summaries tend to obscure the problems that people who create these are trying to solve. This is what makes this part of the job fun.

I’ve read Title XIII-Health Information Technology with an eye toward the things I am most interested in and will quote those passages below, for informational purposes. Remember that this is a blog which means that corrections and improvements are welcome in the comments. And I’m not an attorney, this is for informational purposes only, and there’s good information in here.

Subtitle A – Promotion of Health Information Technology

Section 3000 Definitions

Health Information Technology includes uses by patients:

‘‘(5) HEALTHINFORMATIONTECHNOLOGY.—The term ‘health information technology’ means hardware, software, integrated technologies or related licenses, intellectual property, upgrades, or packaged solutions sold as services that are designed for or support the use by health care entities or patients for the electronic creation, maintenance, access, or exchange of health information

Section 3001 Office of the National Coordinator For Health Information Technology

Support for patient/consumer groups

‘‘(7) ASSISTANCE.—The National Coordinator may provide financial assistance to consumer advocacy groups and not-for- profit entities that work in the public interest for purposes of defraying the cost to such groups and entities to participate under, whether in whole or in part, the National Technology Transfer Act of 1995 (15 U.S.C. 272 note).

Section 3002 HIT Policy Committee

The sections of this Committee’s charge that cover things like patient access and empowerment are listed in “Other Areas For Consideration.” At least they are there at all.

‘(iii) Telemedicine technologies, in order to reduce travel requirements for patients in remote areas. ‘‘(iv) Technologies that facilitate home health care and the monitoring of patients recuperating at home. ‘‘(v) Technologies that help reduce medical errors. ‘‘(vi) Technologies that facilitate the continuity of care among health settings. ‘‘(vii) Technologies that meet the needs of diverse populations. ‘‘(viii) Methods to facilitate secure access by an individual to such individual’s protected health information. ‘‘(ix) Methods, guidelines, and safeguards to facili- tate secure access to patient information by a family member, caregiver, or guardian acting on behalf of a patient due to age-related and other disability, cog- nitive impairment, or dementia. ‘‘(x) Any other technology that the HIT Policy Com- mittee finds to be among the technologies with the greatest potentiof health care.

There is support for patient involvement on the HIT Policy Committee (nominees were sought recently for this Committee):

‘‘(G) 13 members shall be appointed by the Comptroller General of the United States of whom— ‘‘(i) 3 members shall advocates for patients or con- sumers; ‘‘(ii) 2 members shall represent health care pro- viders, one of which shall be a physician; ‘‘(iii) 1 member shall be from a labor organization representing health care workers; ‘‘(iv) 1 member shall have expertise in health information privacy and security;

Section 3003 HIT Standards Committee

Membership to include consumers:

‘‘(2) M.—The membership of the HIT Standards Committee shall at least reflect providers, ancillary healthcare workers, consumers, purchasers, health plans, technology vendors, researchers, relevant Federal agencies, and individuals with technical expertise on health care quality, privacy and security, and information.

Tomorrow, Part II of Title XIII


Hey Ted, couple of questions…

Sure "consumers" or "patients" are represented, but what does that really mean? Everyone who receives healthcare is a consumer, so does the term mean someone who is a consumer AND is not also wearing another "hat" (i.e., not a provider, not an IT vendor, not a payer, etc.). Then HITPC and HITSC could fulfill the "consumer" representation by having any living person. At the other extreme, does "consumer" mean a member of some organized consumer advocacy group? How would you know if there is enough representation of consumers?

What about the recent stories about certain major companies not being sure whether the patient data that they hold is covered under ARRA's privacy provisions? Could that result in a backlash against (or at least lack of positive incentive for) entities that aren't specifically regulated by ARRA?

Hi David,

Thanks for the awesome questions – they are exactly the ones I was hoping to prompt by displaying the language of the bill. So, let's have the conversation – this language is written in the law, and the task is to figure out what the people who wrote the law intended. How would you specify it? Other ideas?

Re: ARRA and privacy – you're skipping ahead, I haven't covered that part yet, and I haven't decided that it would add value for me to comment on that part of the law, since there are so many other smart people doing so. My interest is patient and family involvement in care and in designing the systems that care for them. Stay tuned,


Keeping up with you is always fun and always a challenge. :–)

Here's a minor request, to help me this weekend when I start reading this series: when you post each addition, it helps if you link to it from the end of the previous one.

Me, I just got my hands on Innovator's Prescription so I have some reading on my hands, for a change. :–)

Ted Eytan, MD