American patients and their caretakers will be the ultimate beneficiaries of the following activities aimed at achieving the President’s health IT initiative to accelerate the adoption of health IT and utilization of electronic health records. All of the activities discussed in this section support the current two Federal Health IT Strategic Plan goals:
1. Inform Health Care Professionals: Provide critical information to health care professionals to improve the quality of care delivery, reduce errors, and decrease costs.
2. Improve Population Health: Simplify collection, aggregation, and analysis of anonymized health information for use to improve public health and safety.
• Privacy and Security Spend Plan*: Recovery Act Subtitle D - Utilizing fully competitive contract awards, HHS will implement time-sensitive, mandatory regulatory and enforcement requirements in Subtitle D, providing contract assistance to meet statutory deadlines requiring promulgation of a variety of regulations and guidance, conduct multiple studies, and submit a number of Congressional reports; enhance enforcement of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules by carrying out the extensive changes that Subtitle D makes to the existing HIPAA complaint investigation and enforcement scheme. This funding will enable the Centers for Medicare and Medicaid Services (CMS) and the Office for Civil Rights (OCR) to carry out mandated audits, make modifications in their case and document management systems, and train State Attorneys General in their new enforcement role. The Recovery Act also required that, no later than April 17, 2009, ONC was to issue guidance on technologies and methodologies that render protected health information unusable, unreadable, or indecipherable to unauthorized individuals. This guidance was published in the Federal Register. A fully competitive contract award will be utilized to support the review and disposition of public comments. Final guidance will be published after a public comment period.
• Define “Meaningful Use of an EHR”: Recovery Act §4101- The Recovery Act authorizes that incentive payments may be made to eligible professionals and hospitals that are using EHRs in a meaningful way. Specific understanding of what constitutes meaningful use will be determined through a process that will include broad stakeholder input and discussion. HHS is developing milestones for major phases of the program’s activities with planned delivery dates.
• Recovery Act Public Communications: Recovery Act §3001 (c) (3) (A) (B) (D) - ONC will establish mechanisms for communications with the public, which would include creating a website like healthreform.gov. Through a fully competitive process, ONC will award a contract(s) to provide support in determining the best methods of broad communication and establish the resulting infrastructure. HHS is developing additional milestones for major phases of the program’s activities with planned delivery dates.
Considerations to Address Moving Forward - There are a number of complex issues that must be considered to fully implement the requirements of the HITECH Act and the intent of the Recovery Act. There is foundational work required to support the large investment that will be made through the Medicare and Medicaid Incentives programs at the Centers for Medicare & Medicaid Services (CMS). With the arrival of the new National Coordinator, decisions about how to best address standards development and harmonization, the certification and testing processes, privacy and security policy development, issues around governance, workforce training, and education for health care providers and consumers will be made.
Additionally, a notification for funding availability for the regional extension center grants will be published by the end of FY 2009. Awards are anticipated to be made in early FY 2010.