In a recent article in the New England Journal of Medicine, ONC Director Dr. David Blumenthal provides a succinct overview of the steps taken since the passage of the HITECH provisions of the ARRA.

But while Dr. Blumenthal outlines the many programs that have been launched in recent months to support the implementation of health IT across the country, he also points to an overarching goal that is often cited in HIT discussions, but rarely discussed in depth.

In the article, Dr. Blumenthal states, “On December 30, the government took several critical steps toward a nationwide, interoperable, private, and secure electronic health information system. (DHHS) . . . released two proposed regulations affecting HIT . . . The first, a notice of proposed rule-making (NPRM), describes how hospitals, physicians, and other health care professionals can qualify for billions of dollars of extra Medicare and Medicaid payments through the meaningful use of electronic health records (EHRs). The second, an interim final regulation, describes the standards and certification criteria that those EHRs must meet for their users to collect the payments. In addition, between August and December 2009, my office . . . announced nearly $2 billion worth of new programs to help providers become meaningful users of EHRs and to lay the groundwork for an advanced electronic health information system.”

In addition to a healthy array of programmatic details, including a description of the impact of “meaningful use” of HIT, Dr. Blumenthal also makes the claim that “achieving meaningful use would advance Americans’ health.”

On one level, that claim makes sense. After all, one of the oft-cited benefits of electronic health records is that patients’ medical histories will be accessible no matter where they are. Especially in emergency situations, that could save a patient’s life.

But claiming “achieving meaningful use would advance Americans’ health” brings to mind a number of questions which policymakers should be asking themselves as they decide where to commit public resources in the future. For example, approximately how many Americans will see their health improve as a result of increased use of HIT? Or, by how much, at least roughly, will Americans’ overall health improve? What level of HIT investment will be necessary to improve Americans’ health by, say, 10% on average? Could that money have been spent in other health-related arenas and resulted in the same improvement?

The point is not to question the goals of those who claim that improving HIT will improve general health. That’s a goal we all share. But “improving public health” is, at best, an extremely broad and vague goal that is impacted by a number of factors, including personal behavior.

At the very least, if policymakers are going to point “improved public health” as an expected outcome of public investment in health IT, they should be able to point to some broad calculations that enable taxpayers to get a glimpse at how much healthier they’ll be as a result of the investment.