Senator John D. Rockefeller IV, D-W. Va., introduced legislation last week that will facilitate the nationwide adoption of EHRs, particularly among small, rural providers.

The Health Information Technology Public Utility Act of 2009 will build upon the use of open-source EHRs by the Department of Veterans Affairs as well as the "open-source exchange model," which was recently expanded among federal agencies through the Nationwide Health Information Network-Connect initiative.

"We need advancements in health information technology across the board to improve the quality of care Americans receive," said Rockefeller, chairman of the Senate Finance Subcommittee on Health Care. "To make this happen, we need universal access to affordable and interoperable health information technology--from small, rural health clinics to large, urban hospitals."

Open-source software, or a computer program with unrestricted source code that does not limit the use or distribution by any organization or user, is a cost-effective, proven way to advanace health IT, said Rockefeller. "This legislation does not replace commercial software; instead, it complements the private industry in this field--by making health information technology a realistic option for all providers," he said.

Specifically, the Act would:

• Create a new federal Public Utility Board within the Office of the National Coordinator for Health IT to direct and oversee formation of this HIT Public Utility Model, its implementation, and its ongoing operation.

• Implement and administer a new 21st Century Health IT Grant program for safety-net providers to cover the full cost of open-source software implementation and maintenance for up to five years, with the possibility of renewal for up to five years if required benchmarks are met.

• Facilitate ongoing communication with open-source user groups to incorporate improvements and innovations from them into the core programs.

• Ensure interoperability between these programs, including as innovations are incorporated, and develop mechanisms to integrate open-source software with Medicaid and CHIP billing.

• Create a child-specific EHR to be used in Medicaid, CHIP, and other federal children's health programs.

• Develop and integrate quality and performance measurement into open-source software modules.