Stimulus Programs Aim at Health IT Problems

With a nod toward averting future problems as well as educating the public about current ones, the federal government’s  campaign to move the health care industry into the digital age spawned a couple of offshoots over the past two months.

HHS announced it will award a contract to develop ways to identify “undesirable and potentially harmful” unintended consequences of programs funded and administered by the Office of the National Coordinator for Health Information Technology. That effort includes consideration of the EHR meaningful use incentive program.

In addition, HHS will engage a contractor to support a comprehensive two-year public education campaign that fulfills the HITECH mandate to educate the public about privacy and security of protected health information. The campaign will be jointly led by ONC and the HHS Office for Civil Rights.

Announcement of those two programs highlighted the federal government’s steady march toward implementing various health care provisions of the American Recovery and Reinvestment Act of 2009.  This update summarizes significant developments in the first two months of 2010.

In addition to several health IT-related programs, the government moved forward with several other stimulus package efforts in the health care arena, including community health programs, comparative effectiveness research and broadband expansion.

Funding for EHR Hardware, Software, IT Research

The Health Resources and Services Administration announced $2.4 million in funding for EHR hardware and software to enable organizations to report client level data to HHS through standardized electronic client information data systems. Data shared with HHS will be used to obtain accurate unduplicated client counts, monitor care and assess outcomes associated with services that receive Ryan White HIV/AIDS Program funding.

HHS announced it will award $50 million in task orders to establish a national Health IT Research Center to provide technical assistance to ARRA-funded initiatives such as Regional Extension Centers and Beacon Communities.

The Agency for Healthcare Research and Quality, which will oversee the research center, issued pre-solicitation notices for the following activities to support the HITRC:

  • To provide meaningful educational tools and resources (solicitation number AHRQ-D2-RFTO8);
  • To provide practice transformation support to RECs (solicitation number AHRQ-D2-RFTO7);
  • To provide marketing and outreach support for RECs (solicitation number AHRQ-D3-RFTO-5); and
  • To develop a knowledge sharing network for RECs (solicitation number AHRQ-D2-RFTO6).

The Social Security Administration announced $17.4 million for health care providers and health information exchange networks to facilitate the delivery of patient health information via EHRs through the Nationwide Health Information Network.

Grants for Information Exchange, Extension Centers

HHS announced approximately $386 million in grant awards for the first round of the State Health Information Exchange Cooperative Agreement Program. Forty states and qualified State-Designated Entities received funds to establish and implement plans for statewide health information exchange. Additional awards will be made in the coming weeks.

HHS announced $375 million in awards to an initial 32 non-profit organizations to create regional extension centers (REC) under the Health Information Technology Extension Program that will provide outreach, education and technical assistance that will enable health professionals to use health IT.  Additional awards will be made in the coming weeks.

HHS released four special notices of intent to award contracts in four specific areas:

  • Collection, storage, usage and disclosure of personal health information;
  • NHIN interoperability testing;
  • Open source health IT systems; and
  • Health IT security risks. 

Privacy, Security Issues Take Center Stage

HHS announced that it will be seeking a contractor to engage state consortium projects in addressing and resolving key barriers to interstate health information exchange, such as privacy and security, reconciling patient consent policies, liability issues and varying software interfaces.

HITECH requires HHS to issue guidance on methods for de-identification of protected health information as designated in HIPAA’s medical privacy rule. Because of this, the HHS Office for Civil Rights is soliciting stakeholder input on de-identification approaches, best practices for implementation and management of the current de-identification standard and potential changes to address policy concerns.

ONC has selected Joy Pritts as the agency’s chief privacy officer, a new role established under ARRA. The privacy officer will:

  • Advise the National Coordinator on privacy, security and data stewardship of electronic health information; and
  • Coordinate activities with other federal, state, regional and foreign initiatives.

Comparative Effectiveness Research Gearing Up

The Agency for Healthcare Research and Quality announced $24 million in funding to enhance the electronic clinical capability of existing registries to create and analyze valid data for comparative effectiveness research and monitor and advance quality improvement of clinical care. Applications are due by March 29.

AHRQ released $25 million to develop sustainable systems for the collection of prospective data from electronic clinical databases to generate new evidence on the comparative effectiveness of healthcare interventions. 

The HHS Office of the Assistant Secretary for Planning and Evaluation will issue two competitive task orders to pilot test health data used for “rapid comparative effectiveness analysis” to test the ability to link patient and other data from federal data sets and other sources.

AHRQ announced several comparative effectiveness research-related funding opportunities, including:

  • $13 million to promote the implementation and widespread use of findings from CER that have demonstrated improvements in health care quality and outcomes. Applications are due by March 24th.
  • $7 million to conduct comparative evaluations of alternative system designs, change strategies and interventions that have already been implemented in health care to determine whether they are likely to improve quality and other outcomes such as cost, access to care and reduction of disparities.  Applications are due by March 18.
  • $10 million for organizations to enhance the clinical content of statewide, all-payer, hospital-based encounter-level data to support CER, and improve the reliability and validity of information in hospital-based encounter-level data related to race and ethnicity. Applications are due March 29.
  • $12 million for demonstration projects that aim to improve health care quality through service redesign through its Comparative Effectiveness Research on Delivery Systems initiative.  Applications are due March 23.

AHRQ will award one three-year contract, with two one-year optional additional years, for a contractor to oversee a Citizens Forum that will expand citizen and stakeholder engagement in AHRQ’s CER initiatives. This contract will be awarded by July 12, 2010. The agency will release the funding announcement soon.

Funds for Health IT Workforce Development

The Department of Labor awarded more than $225 million to train 15,000 people in job skills to access careers in health care, IT and other fields. The grants will fund 55 separate training programs in 30 states. Training will be offered at community colleges and other local education providers. Employment services will be available via the department’s local One Stop Career Centers.

Community Health, Broadband Funds Awarded

HHS awarded more than $119 million to states and U.S. territories to support public health efforts to reduce obesity, increase physical activity, improve nutrition, and decrease smoking through its “Communities Putting Prevention To Workinitiative.

The Department of Commerce’s National Telecommunications and Information Administration and the Department of Agriculture’s Rural Utilities Service announced awards under the first round of NTIA’s Broadband Technology Opportunities Program and RUS’ Broadband Initiatives Program. 

NTIA has awarded more than $600 million in its first round of funding.  NTIA also continues to award grants to fund broadband mapping and planning activities through its State Broadband Data and Development Grant Program.

USDA announced the award of more than $309 million to 14 broadband projects to enable access to broadband services to rural un-served and underserved communities.

NTIA and RUS announced the second funding round for BTOP and BIP grant programs.  A total of $4.8 billion will flow through the agencies’ programs. The BTOP Program allocates approximately $2.6 billion as follows:

  • $2.35 billion for infrastructure projects, focusing on middle mile broadband projects that connect key community anchor institutions — such as libraries, hospitals, community colleges, universities and public safety institutions;
  • $150 million for public computer center projects, expanding access to broadband service and enhancing broadband capacity at public libraries, community colleges and other institutions that serve the general public; and
  • $100 million for sustainable broadband adoption projects, enabling projects to provide broadband education, training and equipment, particularly to vulnerable population groups where broadband technology has traditionally been underutilized.

The BIP Program will award a total of $2.2 billion for broadband infrastructure projects.  The agencies are currently accepting applications for the second round of funding through March 15, 2010.

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