Slightly smaller are the chairman's caps Tang wears for two Health IT Policy Committee work groups, one on meaningful use and the other on the national IT strategic plan; and two others as members of Health IT Policy Committee work groups on privacy and security and on quality measures.
Tang, who also serves as the vice president and chief medical information officer of the Palo Alto (Calif.) Medical Foundation, was hatless Tuesday as a featured speaker at the American Health Information Management Association convention in Orlando.
His presentation was on redesigning the U.S. healthcare system using technology—something at which all of his committee work is directed.
Tang said the entire federal effort to leverage $27 billion in incentive payments under the American Recovery and Reinvestment Act of 2009 for the purchase electronic health-record systems is predicated on the "burning platform" of soaring national healthcare costs combined with the looming demographic bulge of the baby boomer generation turning 65 beginning next year.
By 2030, the cohort of the U.S. population age 65 and older will nearly double to 70 million, so that roughly one in five Americans will be older than 65, according to Tang's convention presentation.
In comparison with other countries' health IT subsidy programs, Tang said, the U.S. program—via the stimulus law's meaningful-use requirements—is uniquely and properly focused not on which technologies should be installed but on what outcomes are desired.
The first "payment year" under the federal IT incentive program begins Friday for hospitals and will run through the federal fiscal year ending Sept. 30, 2011. During that period, to qualify for incentive payments, hospitals must string together at least 90 consecutive days of meeting Stage 1 meaningful-use criteria with their EHR systems.
But Tang and fellow members of the meaningful-use work group began meeting last week to develop Stage 2 criteria for use in fiscal years 2013 and 2014.
Tang said the work group hopes to have feedback from hospitals and office-based physicians by April about what's working and what's not with the Stage 1 standards and then make its final recommendations to the Health IT Policy Committee on Stage 2 meaningful-use criteria by the middle of 2011. But that means there will be a time crunch for Stage 2 criteria development and federal rulemaking.
The HIT Policy Committee previously approved a recommendation that IT vendors be given at least 18 months to reconfigure their systems to meet final Stage 2 criteria. At this point, that much space between the creation of new meaningful-use rules and the Stage 2 start date won't be possible.
"Ideally they want 18 months, but HHS can't get their rules out" in that short of a time frame, Tang said.