Stimulus bill implementation: expanding meaningful use of health IT.

The American Recovery and Reinvestment Act authorizes an estimated $38 billion in incentives and supports for health information technology (IT) from 2009 to 2019. After years of sluggish HIT adoption, this crisis-driven investment of public funds creates a unique opportunity for rapid diffusion of a technology that is widely expected to improve care, save money, and facilitate transformation of the troubled U.S. health system. Achieving maximal effect from the stimulus funds is nevertheless a difficult challenge. The Recovery Act strengthens the federal government's leadership role in promoting HIT. But successful adoption and utilization across the health system will also require development of a supportive infrastructure and broad-based efforts by providers, vendors, state-based agencies, and other health system stakeholders. Optimal use of IT for health care may require extensive reengineering of medical practice and of existing systems of payment. The future course of HIT adoption will also be subject to the effects of any health care reform legislation and of technological innovation in the fast-changing world of electronic communications