Many, myself included, were disappointed that President Obama failed to mention HIT in his State of the Union address. At the same time, I cannot read that as a bad omen regarding his continued support. Perhaps it was to tell the industry that the time has come to show results from the major HITECH stimulus and move to sustainability.

At the very least, there is near-universal belief that effective HIT is an absolute requirement of the collaborative care model heralded as most likely to achieve the triple aim of better care for individuals, better health for populations and lower growth of Medicare expenditures. The EHR is fundamental. We also need, at a minimum, highly capable patient registries, information exchange, analytics tools and portals for direct patient engagement.

The taxpayers have done a great job in accelerating EHR adoption, but I would not expect a HITECH Part Two to fund these needs. I would, however, expect continued funding of ONC to complete the job it has begun. Among these unfinished tasks are the continued maturation of HIE and information exchange standards, while we providers determine what is right for our communities and as we evolve toward consistent nomenclatures within our care settings. (It’s not just our vendors who resist interoperability!) The ONC is getting smarter, listening to the many of us in multiple venues and learning from initiatives like RECs and Beacon Communities, which exemplify both the critical success factors and the diversity of the U.S. delivery model.

In an era of tightened federal budgets, we are likely to see fewer, more focused pilots, with much greater accountability for the results.