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HRSA’s Office of HRSA’s Office of Health Information Health Information

TechnologyTechnology Cheryl Austein Casnoff, MPHCheryl Austein Casnoff, MPH

U.S. Department of Health and Human U.S. Department of Health and Human ServicesServices

Health Resources and Services Health Resources and Services AdministrationAdministration

Office of Health Information TechnologyOffice of Health Information Technology

Challenging our Health Care Challenging our Health Care SystemSystem

►We need to use our health care We need to use our health care resources more effectively than we do resources more effectively than we do todaytoday

►We need to focus on quality and valueWe need to focus on quality and value►We can achieve real change and far-We can achieve real change and far-

reaching results when HIT is in placereaching results when HIT is in place

Carolyn Clancy, M.D., DirectorCarolyn Clancy, M.D., Director

Agency for Healthcare Research and Quality (AHRQ), Agency for Healthcare Research and Quality (AHRQ),

US Department of Health and Human ServicesUS Department of Health and Human Services

Why We Need HITWhy We Need HITThe best evidence suggests:The best evidence suggests:► People receive only half the preventive care People receive only half the preventive care

recommended recommended ► People with acute or chronic conditions People with acute or chronic conditions

receive receive about two-thirds of the care they need about two-thirds of the care they need

► About one-fifth to one-third of both acute and About one-fifth to one-third of both acute and chronic care is unnecessary chronic care is unnecessary

““Taking the Pulse of Health Care in AmericaTaking the Pulse of Health Care in America,”,” Mark A. Schuster, Elizabeth Mark A. Schuster, Elizabeth A. McGlynn, Robert H. Brook, Rand Corporation, 1998 A. McGlynn, Robert H. Brook, Rand Corporation, 1998

Real Time ResultsReal Time Results► HIT can facilitate measurement of outcomes and HIT can facilitate measurement of outcomes and

evaluation of interventions in real-time rather evaluation of interventions in real-time rather than from a retrospective perspectivethan from a retrospective perspective

► HIT can facilitate communication and coordination HIT can facilitate communication and coordination

of care among care team participantsof care among care team participants► HIT allows tracking of patient health indicators HIT allows tracking of patient health indicators

over timeover time

Sarah Chouinard, MD and Jack L. Shaffer, Jr., “Improving Patient Health Outcomes at Primary Sarah Chouinard, MD and Jack L. Shaffer, Jr., “Improving Patient Health Outcomes at Primary Care Systems in Clay, WV Using and Electronic Health Management System,” 12/02/2007Care Systems in Clay, WV Using and Electronic Health Management System,” 12/02/2007

HIT and Systems Savings - EfficiencyHIT and Systems Savings - Efficiency

► Properly implemented and widely adopted, HIT Properly implemented and widely adopted, HIT would save money and significantly improve would save money and significantly improve health care qualityhealth care quality

► Annual savings from efficiency alone could Annual savings from efficiency alone could average $77 billion or more per year in both average $77 billion or more per year in both inpatient and outpatient careinpatient and outpatient care

► Largest savings come from reduced hospital Largest savings come from reduced hospital stays resulting from increased safety and better stays resulting from increased safety and better scheduling and coordination, reduced nurses’ scheduling and coordination, reduced nurses’ administrative time, and more efficient drug administrative time, and more efficient drug utilizationutilization

Rand Health, Research Highlights, “Health Information Technology, Can HIT Lower Costs and Improve Rand Health, Research Highlights, “Health Information Technology, Can HIT Lower Costs and Improve Quality ?” 2005Quality ?” 2005

HIE Enabled Chronic Care ManagementHIE Enabled Chronic Care Management

► Improves diagnostic accuracy by providing Improves diagnostic accuracy by providing prompts, alerts and reminders built around prompts, alerts and reminders built around evidence based guidelines and real time evidence based guidelines and real time clinical knowledgeclinical knowledge

► Reduces adverse drug interactions and Reduces adverse drug interactions and dosing complications, permits the PCP to dosing complications, permits the PCP to monitor monitor script refills, avoid hospital utilization, and script refills, avoid hospital utilization, and improve treatment plan adherenceimprove treatment plan adherence

““Coordinating Chronic Care Management through HIEs,” Deloitte Center for Health Coordinating Chronic Care Management through HIEs,” Deloitte Center for Health Solutions.2007 Solutions.2007

HIE Enabled Chronic Care ManagementHIE Enabled Chronic Care Management

► Facilitates interaction between the provider and Facilitates interaction between the provider and the patient by providing real-time knowledge about a the patient by providing real-time knowledge about a patient between visits and reducing avoidable patient between visits and reducing avoidable complications and costs from unmanaged chronic complications and costs from unmanaged chronic conditionsconditions

► Allows all team providers to work with the physician Allows all team providers to work with the physician and patient to determine the best course of self-care and patient to determine the best course of self-care management and to share information to better management and to share information to better coordinate care, monitor outcomes and avoid coordinate care, monitor outcomes and avoid complicationscomplications

““Coordinating Chronic Care Management through HIEs,” Deloitte Center for Health Coordinating Chronic Care Management through HIEs,” Deloitte Center for Health Solutions.2007 Solutions.2007

Lower Costs for Chronic Care Lower Costs for Chronic Care ManagementManagement

► HIT can improve diagnostic accuracy, enhance HIT can improve diagnostic accuracy, enhance coordination among members of the care team, coordination among members of the care team, enable regular and frequent patient coaching, enable regular and frequent patient coaching,

and avoid hospital admissions and emergency and avoid hospital admissions and emergency room visitsroom visits

► This will lower overall health care costs and has This will lower overall health care costs and has the potential to produce a substantial ROI for a the potential to produce a substantial ROI for a community or organizationcommunity or organization

““Coordinating Chronic Care Management through HIEs,” Deloitte Center for Health Coordinating Chronic Care Management through HIEs,” Deloitte Center for Health Solutions.2007Solutions.2007

Major Congenital Malformations

after First-Trimester

Exposure to ACE Inhibitors

Using the EHR to Support Using the EHR to Support Population- Based Care in Health Population- Based Care in Health

CentersCenters

Source: The Institute for Family Health, Dr. Neil Calman, CEO (New York)

Savings from Telehealth Savings from Telehealth

► Reduced face-to-face visits and redundant and Reduced face-to-face visits and redundant and unnecessary tests could save $3.61 billion/year unnecessary tests could save $3.61 billion/year

► Of the 142 million referral visits in the US per Of the 142 million referral visits in the US per

year, reduction in patient travel from mileage year, reduction in patient travel from mileage costs could save $912 millioncosts could save $912 million

► Nationally implemented telehealth systemsNationally implemented telehealth systems

could save $4.28 billion annuallycould save $4.28 billion annually

““The Value of Provider-to-Provider Telehealth Technologies ,” Center for Information The Value of Provider-to-Provider Telehealth Technologies ,” Center for Information Technology Leadership, 2007Technology Leadership, 2007

Savings from TelehealthSavings from Telehealth

► Reduced emergency department transfers Reduced emergency department transfers Avoid 850,000 transfers with a cost savings of $537m/yrAvoid 850,000 transfers with a cost savings of $537m/yr

► Reduced transfers from correctional facilities to Reduced transfers from correctional facilities to emergency departments and physician offices emergency departments and physician offices Avoid 40,000 transports with a cost savings of $60m/yrAvoid 40,000 transports with a cost savings of $60m/yr

► Reduced transfers from nursing home facilities to Reduced transfers from nursing home facilities to emergency departments and physician offices emergency departments and physician offices Avoid 370,000 transports to ERs with a cost savings of Avoid 370,000 transports to ERs with a cost savings of

$327m/yr and 6.8 m transports to physician offices with a $327m/yr and 6.8 m transports to physician offices with a cost savings of $479m/yrcost savings of $479m/yr

““The Value of Provider-to-Provider Telehealth Technologies ,“ Center for The Value of Provider-to-Provider Telehealth Technologies ,“ Center for Information Technology Leadership, 2007Information Technology Leadership, 2007

Savings from Computerized Physician Savings from Computerized Physician Order Entry (CPOE)Order Entry (CPOE)

Nationwide adoption of CPOE is expected to:Nationwide adoption of CPOE is expected to:► Eliminate 2 million adverse drug eventsEliminate 2 million adverse drug events► Eliminate more than 190,000 hospitalizations per Eliminate more than 190,000 hospitalizations per

yearyear► Save the US health care system some $44 Save the US health care system some $44

billion/year in reduced medication, radiology, lab billion/year in reduced medication, radiology, lab and adverse drug eventsand adverse drug events

““The Value of CPOE in Ambulatory Settings,” Center for Information Technology The Value of CPOE in Ambulatory Settings,” Center for Information Technology Leadership, March 2003Leadership, March 2003

Using HIT to Measure Impacts Using HIT to Measure Impacts on Patientson Patients

► We can use HIT to measure the different We can use HIT to measure the different effects of a treatment for different patientseffects of a treatment for different patients

► We can spot unexpected patterns of success We can spot unexpected patterns of success or unexpected safety concernsor unexpected safety concerns

► We can identify and address health We can identify and address health disparitiesdisparities

► We can detect these patterns in real time We can detect these patterns in real time and put what we have learned into effectand put what we have learned into effect

Carolyn Clancy, M.D., DirectorCarolyn Clancy, M.D., DirectorAgency for Healthcare Research and Quality (AHRQ), Agency for Healthcare Research and Quality (AHRQ), US Department of Health and Human ServicesUS Department of Health and Human Services

Reductions in HgbA1c with Reductions in HgbA1c with Treatment by Race /LanguageTreatment by Race /Language

6.5

7

7.5

8

8.5

White 7.23 6.95

Black 7.80 7.44

Latino-Eng 8.02 7.75

Latino- Span 8.12 7.81

Other 7.82 7.48

1st HgbA1C Most Recent

Source: The Institute for Family Health, Dr. Neil Calman, CEO (New York)

2007 HIT Adoption2007 HIT Adoption

► Four percent of physicians reported having an Four percent of physicians reported having an extensive, fully functional electronic records systemextensive, fully functional electronic records system

► Thirteen percent reported having a basic system Thirteen percent reported having a basic system ► Physicians in large groups, hospitals or medical Physicians in large groups, hospitals or medical

centers, and in the western region of the US were centers, and in the western region of the US were more likely to use electronic health recordsmore likely to use electronic health records

► Physicians reported positive effects of systems on Physicians reported positive effects of systems on quality of care and high levels of satisfaction quality of care and high levels of satisfaction

► Financial barriers were viewed as having the Financial barriers were viewed as having the greatest effect on decisions about the adoption of greatest effect on decisions about the adoption of EHRsEHRs

N Engl J Med 2008;359:50-60N Engl J Med 2008;359:50-60

2007 HIT Adoption - Conclusions2007 HIT Adoption - Conclusions

► Physicians who use electronic health records believe Physicians who use electronic health records believe such systems improve the quality of care and are such systems improve the quality of care and are generally satisfied with the systemsgenerally satisfied with the systems

► However, as of early 2008, electronic systems had However, as of early 2008, electronic systems had been adopted by only a small minority of U.S. been adopted by only a small minority of U.S. physicians, physicians, who may differ from later adopters of these systemswho may differ from later adopters of these systems

► The survey found that doctors who treat the wealthy The survey found that doctors who treat the wealthy and those who treat the disadvantaged use the and those who treat the disadvantaged use the technology at about the same rate technology at about the same rate

N Engl J Med 2008;359:50-60N Engl J Med 2008;359:50-60

Electronic PrescribingElectronic Prescribing

The American Medical Association estimates that The American Medical Association estimates that only 6 percent of providers of ambulatory care use only 6 percent of providers of ambulatory care use electronic prescribing although potentially half of electronic prescribing although potentially half of all prescriptions could be made electronicallyall prescriptions could be made electronically

Although nearly all large-chain pharmacies have Although nearly all large-chain pharmacies have activated e-prescribing systems, only 27 percent of activated e-prescribing systems, only 27 percent of small neighborhood pharmacies have done sosmall neighborhood pharmacies have done so

Fifteen percent of U.S. physicians write half of all Fifteen percent of U.S. physicians write half of all prescriptions, and 30 percent write 80 percent, an prescriptions, and 30 percent write 80 percent, an important factor in applying strategies to increase important factor in applying strategies to increase adoption and useadoption and use

Health Resources and Services Health Resources and Services Administration (HRSA)Administration (HRSA)

► Helps provide a safety net of health care Helps provide a safety net of health care services to 20 million people each year - services to 20 million people each year - about 1 in every 15 Americans. Budget of about 1 in every 15 Americans. Budget of approximately $7 billion in FY09.approximately $7 billion in FY09.

► Six bureaus: Maternal and Child Health, Six bureaus: Maternal and Child Health, HIV/AIDS, Primary Health Care, Health HIV/AIDS, Primary Health Care, Health Professions, Health Systems, and Clinician Professions, Health Systems, and Clinician Recruitment and Service.Recruitment and Service.

► 14 offices including Offices of Rural Health 14 offices including Offices of Rural Health Policy, Minority Health and Health Disparities, Policy, Minority Health and Health Disparities, International Health, Health Information International Health, Health Information Technology, and the Center for Quality.Technology, and the Center for Quality.

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Office of Health Information Technology Office of Health Information Technology (OHIT)(OHIT)

► Formed in December 2005Formed in December 2005► Mission:Mission:

The Office of Health Information Technology (OHIT) The Office of Health Information Technology (OHIT) promotes the adoption and effective use of health promotes the adoption and effective use of health information technology (HIT) in the safety net information technology (HIT) in the safety net community.community.

OHIT Includes:OHIT Includes: Division of Health Information Technology PolicyDivision of Health Information Technology Policy Division of Health Information Technology State Division of Health Information Technology State

and Community Assistance and Community Assistance Office for the Advancement of TelehealthOffice for the Advancement of Telehealth

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HIT Goals for the Safety Net HIT Goals for the Safety Net ProvidersProviders

Bring HIT to America’s safety net Bring HIT to America’s safety net providers which will:providers which will:

Improve quality of careImprove quality of care Reduce health disparities Reduce health disparities Increase efficiency in care delivery Increase efficiency in care delivery

systemssystems Increase patient safetyIncrease patient safety Decrease medical errorsDecrease medical errors Prevent a digital dividePrevent a digital divide Allow providers to participate in pay Allow providers to participate in pay

for performancefor performance

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What OHIT DoesWhat OHIT Does► Award planning and implementation grants for Award planning and implementation grants for

telehealth, electronic health records, and other telehealth, electronic health records, and other health information technology innovationshealth information technology innovations

► Provide technical assistance to HRSA grantees Provide technical assistance to HRSA grantees and staff (e.g., project officers and Office of and staff (e.g., project officers and Office of Performance Review) related to effective HIT Performance Review) related to effective HIT adoption and Federal and state policies and adoption and Federal and state policies and legislationlegislation

► Provide leadership and representation for HRSA Provide leadership and representation for HRSA grantees with Federal and state policymakers, grantees with Federal and state policymakers, researchers, and other stakeholdersresearchers, and other stakeholders

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DSCA FY 09 Grant OpportunitiesDSCA FY 09 Grant Opportunities► Division of HIT State and Community Division of HIT State and Community

Assistance offers the following grant Assistance offers the following grant opportunities in FY 2009:opportunities in FY 2009:

1.1. Electronic Health Record Implementation Electronic Health Record Implementation for Health Center Controlled Networks for Health Center Controlled Networks Grant Grant

2.2. Health Information Technology Health Information Technology Implementation for Health Center Implementation for Health Center Controlled Networks Grant Controlled Networks Grant

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HRSA Telehealth Grant HRSA Telehealth Grant AwardsAwards

►First awards made by ORHP in 1989First awards made by ORHP in 1989►Awarded over $250 million in grants Awarded over $250 million in grants

since 1989since 1989►HRSA created Office for the HRSA created Office for the

Advancement of Telehealth as a focal Advancement of Telehealth as a focal point for Telehealth activities in 1998 point for Telehealth activities in 1998

►Competitive and Congressionally-Competitive and Congressionally-mandated projectsmandated projects

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OAT FY 09 Grant OAT FY 09 Grant OpportunitiesOpportunities

►Office for the Advancement of Telehealth Office for the Advancement of Telehealth (OAT) offers the following grant (OAT) offers the following grant opportunities in FY 09:opportunities in FY 09: Telehealth Network Grant ProgramTelehealth Network Grant Program Licensure Portability Grant ProgramLicensure Portability Grant Program Telehealth Resource Center Grant ProgramTelehealth Resource Center Grant Program

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HRSA Health IT ToolboxHRSA Health IT Toolbox

► A comprehensive online compilation of A comprehensive online compilation of health IT planning, implementation and health IT planning, implementation and evaluation resources to support the evaluation resources to support the implementation of health IT for safety net implementation of health IT for safety net providers. providers.

► The HRSA Health IT Toolbox is available to The HRSA Health IT Toolbox is available to the public at: the public at: http://healthit.ahrq.gov/toolbox

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HIT Toolbox Learning Modules -HIT Toolbox Learning Modules - Eleven Eleven topic-specific learning modules cover the life topic-specific learning modules cover the life cycle of a typical health IT implementation cycle of a typical health IT implementation from learning the basics to evaluation and from learning the basics to evaluation and

optimization of a system:optimization of a system:

1. Introduction to Health IT1. Introduction to Health IT2. Getting Started2. Getting Started3. Opportunities for Collaboration3. Opportunities for Collaboration4. Project Management and Oversight4. Project Management and Oversight5. Planning for Technology Implementation5. Planning for Technology Implementation6. Organizational Change Management and Training6. Organizational Change Management and Training7. System Implementation7. System Implementation8. Evaluating, Optimizing, and Sustaining8. Evaluating, Optimizing, and Sustaining9. Advanced Topics9. Advanced Topics10.10.Open Source and Public Domain SoftwareOpen Source and Public Domain Software11.11.Privacy and SecurityPrivacy and Security

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HIT Toolbox Learning HIT Toolbox Learning Modules (cont)Modules (cont)

OHIT is currently working on developing the OHIT is currently working on developing the following learning modules to augment the following learning modules to augment the HIT Adoption Toolbox in 2009.HIT Adoption Toolbox in 2009. Network DevelopmentNetwork Development Personal Health RecordsPersonal Health Records E-prescribingE-prescribing Quality ImprovementQuality Improvement

OHIT is also working with the Office of Rural OHIT is also working with the Office of Rural Health Policy to develop a toolbox specific to Health Policy to develop a toolbox specific to Rural providers.Rural providers.

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Children’s Health IT Toolbox Children’s Health IT Toolbox Proposed “Starting Point” ModulesProposed “Starting Point” Modules

1.1. Introduction to Children’s Health IT Introduction to Children’s Health IT 2.2. Developing Pediatric Friendly EMRS Developing Pediatric Friendly EMRS 3.3. Building a Medical Home for Children Building a Medical Home for Children 4.4. Cross Sector Coordination and Planning for Cross Sector Coordination and Planning for

Children’s Health Children’s Health 5.5. Facilitating Enrollment in Public Health Facilitating Enrollment in Public Health

Insurance Programs Insurance Programs 6.6. Involving Family Members in Their Child’s Involving Family Members in Their Child’s

Healthcare Healthcare 7.7. Improving Quality with Children’s Health IT Improving Quality with Children’s Health IT 8.8. Advanced Topics on Leadership and Advanced Topics on Leadership and

Organizational Design Organizational Design

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TA - HIT TA CenterTA - HIT TA Center► Provide consistent HIT TA to HRSA grantees.Provide consistent HIT TA to HRSA grantees.► TA “One to Many" Webinars TA “One to Many" Webinars

Slides, transcripts and recordings of calls Slides, transcripts and recordings of calls are on the HRSA Health IT Community.are on the HRSA Health IT Community.

► Peer-to-peer technical assistance to obtain Peer-to-peer technical assistance to obtain TA from an experienced peer in HIT.TA from an experienced peer in HIT.

► Consultant technical assistance to obtain TA Consultant technical assistance to obtain TA from an experienced consultant in HIT.from an experienced consultant in HIT.

► Small, regional, interactive workshops on Small, regional, interactive workshops on HIT adoption with health center networks HIT adoption with health center networks and other HRSA grantees that have and other HRSA grantees that have implemented HIT as hosts.implemented HIT as hosts.

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Past HIT WebinarsPast HIT Webinars►Over 3,000 HRSA grantees and staff Over 3,000 HRSA grantees and staff

have participated in a wide range of have participated in a wide range of webinars including:webinars including: HIT 101HIT 101 Important Factors to Consider When Selecting an Important Factors to Consider When Selecting an

EHR SystemEHR System Collaboration (How do I collaborate with networks, Collaboration (How do I collaborate with networks,

other groups, state entities, etc.)other groups, state entities, etc.) Telehealth 101Telehealth 101 Financing HITFinancing HIT Readiness Assessments for HITReadiness Assessments for HIT HIE 101HIE 101 HIT for Special PopulationsHIT for Special Populations Using EHRs to Drive Quality ImprovementUsing EHRs to Drive Quality Improvement

Past HIT WebinarsPast HIT Webinars►Webinars are all archived: Webinars are all archived:

http://healthit.ahrq.gov/login►A password and log in is required to A password and log in is required to

access the portal. access the portal. ►To obtain this, email the request to To obtain this, email the request to

healthit@hrsa.gov

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Future WebinarsFuture Webinars

April 2009 – April 2009 – Personal Health Personal Health RecordsRecordsMay 2009 – May 2009 – HIT and Sustainability for HIT and Sustainability for

Rural SettingsRural Settings

June 2009 – June 2009 – Due Diligence – What is it? Due Diligence – What is it?

Why should I do it?Why should I do it?

July 2009 – July 2009 – Disaster Recover Plans for Disaster Recover Plans for HITHIT

August 2009 – August 2009 – Public Health InformaticsPublic Health Informatics

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HIT WorkshopsHIT Workshops

► OHIT partners with Health Center Controlled OHIT partners with Health Center Controlled Networks and other HRSA grantees who have Networks and other HRSA grantees who have implemented HIT to provide Regional workshops implemented HIT to provide Regional workshops around the country to foster learning and network around the country to foster learning and network development among HRSA grantees who have not development among HRSA grantees who have not implemented HIT.implemented HIT.

► In 2008 the following workshops were provided:In 2008 the following workshops were provided: 4 EHR implementation workshops hosted by 4 EHR implementation workshops hosted by

► Community Health Access Network and the Maine PrimaryCommunity Health Access Network and the Maine Primary

Care Association in Portland, ME; Care Association in Portland, ME; ► Delta Health Alliance in Tunica, MS; Delta Health Alliance in Tunica, MS; ► Chicago Health Alliance in Chicago, IL; Chicago Health Alliance in Chicago, IL; ► OCHIN in Portland, OR.OCHIN in Portland, OR.

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HIT Workshops 2009HIT Workshops 2009 In 2009 OHIT is planning to provide 12 regional workshops In 2009 OHIT is planning to provide 12 regional workshops

including:including: EHR implementation EHR implementation HIE HIE Open source EHR solutionsOpen source EHR solutions EHR that focuses on child health and pediatric EHR that focuses on child health and pediatric

EHR functionality EHR functionality E-prescribing or tele-pharmacyE-prescribing or tele-pharmacy ““Meaningful use” of EHRs to improve quality and Meaningful use” of EHRs to improve quality and

patient outcomespatient outcomes Sustainability, personal health records, and other Sustainability, personal health records, and other

advanced topics for operational networksadvanced topics for operational networks Critical Access Hospitals and other Rural HITCritical Access Hospitals and other Rural HIT Telehealth for rural and urban communities and Telehealth for rural and urban communities and

health centershealth centers

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President Obama’s PledgePresident Obama’s Pledge

►On January 8, 2009, President-elect Barack On January 8, 2009, President-elect Barack Obama pledged to have electronic medical Obama pledged to have electronic medical records for all Americans within 5 years: records for all Americans within 5 years: "To improve the quality of our health care while "To improve the quality of our health care while lowering its costs, we will make the immediate lowering its costs, we will make the immediate investments necessary to ensure that within five investments necessary to ensure that within five years, all of America's medical records are years, all of America's medical records are computerized," Obama said. "This will cut waste, computerized," Obama said. "This will cut waste, eliminate red tape and reduce the need to repeat eliminate red tape and reduce the need to repeat expensive medical tests. But it just won't save expensive medical tests. But it just won't save billions of dollars and thousands of jobs, it will save billions of dollars and thousands of jobs, it will save lives by reducing the deadly but preventable lives by reducing the deadly but preventable medical errors that pervade our health care medical errors that pervade our health care system." system."

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Summary of American Recovery and Summary of American Recovery and Reinvestment Act (ARRA) HIT FundingReinvestment Act (ARRA) HIT Funding

► Total $19.2 billion for HIT, including: Total $19.2 billion for HIT, including: $2 billion for ONC $2 billion for ONC $17.2 billion for incentives through Medicare and $17.2 billion for incentives through Medicare and

Medicaid reimbursement systems Medicaid reimbursement systems ► Providers must demonstrate meaningful use of certified Providers must demonstrate meaningful use of certified

EHR technology EHR technology

► Codifies: Codifies: ONC; HIT Standards Committee; HIT ONC; HIT Standards Committee; HIT Policy Standards Policy Standards

► Provides grant and loan programs to assist Provides grant and loan programs to assist providers and consumers in providers and consumers in adopting/utilizing HIT adopting/utilizing HIT

► Privacy and security provisions in HIPAA for Privacy and security provisions in HIPAA for electronic health info electronic health info

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Summary of ARRA HIT Funding (cont)Summary of ARRA HIT Funding (cont)

►Additional HIT funding Additional HIT funding $4.7 billion for Broadband Technology $4.7 billion for Broadband Technology

Opportunities Program (NTIA) Opportunities Program (NTIA) $2.5 billion for US Department of $2.5 billion for US Department of

Agriculture Distance Learning, Agriculture Distance Learning, Telemedicine, Broadband Program Telemedicine, Broadband Program

$500 million for Social Security $500 million for Social Security Administration Administration

$85 million for Indian Health Service$85 million for Indian Health Service $50 million for Veterans Administration $50 million for Veterans Administration

HRSA ARRAHRSA ARRA

►The Recovery Act has directed $2 billion The Recovery Act has directed $2 billion

to HRSA to expand some of our primary to HRSA to expand some of our primary health care programshealth care programs

►Another $300 million is intended to Another $300 million is intended to support the National Health Service support the National Health Service Corps Corps

►An additional $200 million will support An additional $200 million will support our health professions programsour health professions programs

HRSA ARRAHRSA ARRA

►On March 2, HRSA announced grants On March 2, HRSA announced grants

worth $155 million to establish 126 worth $155 million to establish 126 new health centers new health centers

►Those grants mean another 750,000 Those grants mean another 750,000

people in 39 states and two territories people in 39 states and two territories will have access to health carewill have access to health care

HRSA ARRAHRSA ARRA► On March 27, HRSA released $338 million to expand On March 27, HRSA released $338 million to expand

services offered at the nation’s community health services offered at the nation’s community health centerscenters

► The grants -- titled Increased Demand for Services The grants -- titled Increased Demand for Services (IDS) grants -- will be distributed to 1,128 federally (IDS) grants -- will be distributed to 1,128 federally qualified health center grantees  qualified health center grantees 

► Health centers will use the funds over the next two Health centers will use the funds over the next two years to create or retain approximately 6,400 health years to create or retain approximately 6,400 health center jobscenter jobs

► Later this year, HRSA will award about $1.5 billion in Later this year, HRSA will award about $1.5 billion in health center grants to fund capital improvements health center grants to fund capital improvements and support health information technology and support health information technology investmentsinvestments

HRSA ARRAHRSA ARRA

► Today, more than 3,800 Corps physicians, Today, more than 3,800 Corps physicians, dentists, advance practice nurses and mental dentists, advance practice nurses and mental health professionals treat 4 million patients in health professionals treat 4 million patients in underserved communities nationwide, about underserved communities nationwide, about

half of them in health centershalf of them in health centers► With the Recovery Act dollars, we are With the Recovery Act dollars, we are

projecting the ability to place another 4,000 projecting the ability to place another 4,000 clinicians this year, which will effectively clinicians this year, which will effectively double the number double the number

of clinicians we have in the field of clinicians we have in the field

HRSA and Health ReformHRSA and Health Reform

► The expansion of the health center network is a The expansion of the health center network is a major element in President Obama’s plan to reform major element in President Obama’s plan to reform health care. He wants the following principles to be health care. He wants the following principles to be reflected in any health reform legislation he signs:reflected in any health reform legislation he signs: It must protect families’ financial health;It must protect families’ financial health; It must assure affordable, quality health coverage for all It must assure affordable, quality health coverage for all

Americans;Americans; Its insurance options must be portable and guarantee Its insurance options must be portable and guarantee

choice of doctors;choice of doctors; It must invest in prevention and wellness;It must invest in prevention and wellness; It must improve patient safety and quality of care;It must improve patient safety and quality of care; It must end barriers to coverage for people with pre-It must end barriers to coverage for people with pre-

existing medical conditions; andexisting medical conditions; and It must reduce the long-term growth of health care costs It must reduce the long-term growth of health care costs

for businesses and government.for businesses and government.

CHIP ReauthorizationCHIP Reauthorization► $20 million for <10 grants to conduct $20 million for <10 grants to conduct

demonstration projects to evaluate demonstration projects to evaluate promising ideas for improving the quality promising ideas for improving the quality of children's health care of children's health care Eligible: States and child health providers Eligible: States and child health providers

► $5 million for development of model EHR $5 million for development of model EHR for children enrolled in SCHIP or Medicaidfor children enrolled in SCHIP or Medicaid Secretary to establish program to Secretary to establish program to

encourage development and disseminationencourage development and dissemination

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Future of OHITFuture of OHIT► Promote effective HIT adoption in the safety net to Promote effective HIT adoption in the safety net to

improve quality of care, patient outcomes, and access improve quality of care, patient outcomes, and access to care in support of ARRA activitiesto care in support of ARRA activities

► Provide oversight, monitoring, and technical assistance Provide oversight, monitoring, and technical assistance to grantees to promote successful adoption of HITto grantees to promote successful adoption of HIT

► Continue to develop and promote effective technical Continue to develop and promote effective technical assistance tools such as toolbox modules, webinars, assistance tools such as toolbox modules, webinars, and workshopsand workshops

► Promote the adoption of CCHIT-certified, interoperable, Promote the adoption of CCHIT-certified, interoperable, and fully functional HITand fully functional HIT

► Continue to build partnerships internal to HRSA, with Continue to build partnerships internal to HRSA, with external organizations, and within the granteeexternal organizations, and within the grantee communitycommunity

Contact InformationContact InformationCheryl Austein Casnoff, MPHCheryl Austein Casnoff, MPH

Associate AdministratorAssociate Administrator

DHHS/HRSA/OHITDHHS/HRSA/OHIT

5600 Fishers Lane, 7C-225600 Fishers Lane, 7C-22

Rockville, MD 20857Rockville, MD 20857

Phone: 301-443-0210Phone: 301-443-0210

Fax: 301-443-1330Fax: 301-443-1330

Caustein-casnoff@hrsa.govCaustein-casnoff@hrsa.govhttp://www.hrsa.gov/healthit/