In late December, President George W. Bush signed a new spending bill that leaves the Office of the National Coordinator for Health Information Technology (ONCHIT) with the same budget for the current fiscal year as 2007—a total of $61.3 million.
According to Robert Kolodner, MD, national coordinator for health IT, when asked about the ramifications of working with a flat budget rather than the much larger one the administration had requested, ONCHIT will be able to “continue making progress, just as we’ve been making progress over these last two years at the current budget. It means we won’t be able to accelerate in the ways we had hoped” or start certain new projects, he said.
Efforts to develop a Nationwide Health Information Network (NHIN) will take the biggest hit, Kolodner said. The office had awarded contracts to nine communities for NHIN trial implementations and planned to add more communities this year, but Kolodner said this is no longer possible.
The proposed budget also would have allowed ONCHIT to sponsor projects to demonstrate the value of use cases, or health IT application scenarios, which form the backbone of the office’s approach to its mission. These demonstrations—other than one already under way on secure messaging among doctors—won’t happen this year, according to Kolodner. A third project that will be postponed involved work on the architecture of personal health records, he added.
He said his staff is still analyzing the impact of the smaller budget. “We’re looking to see what we can do to leverage other activities that are going on or to find alternative ways to achieve the goals that we had in some areas,” he said.
The office is responsible for meeting President Bush’s goal of having an electronic health record for every American by 2014. “We think we can still achieve that goal,” Kolodner said, “but ONCHIT will need bigger budgets in the years to come.”