For 36 years I worked on the technology side of medical information systems. Around 2010 it became obvious to me that the HITECH program under ARRA would be extremely disruptive.
Not only did HITECH distort the market in significant ways, it failed to produce the intended benefits. One effect of HITECH was hospitals that were already using electronic health records were able to switch vendors and buy more expensive systems, knowing that the government would reimburse them if they met the “meaningful use” requirements.
Kaiser Health News and Fortune Magazine have published a lengthy report on what went wrong.
At the same time that hospital decision makers were looking forward to their HITECH reimbursements, the big players went on merger and acquisition binges, creating large regional medical systems. Left behind were many small rural hospitals, called Critical Access Hospitals, that rely upon Medicaid and Medicare money. Many have closed, either because they didn’t have a buyer or, as covered in a recent Nashville Tennessean story, they chose to remain independent.