ONC outlines HITECH implementations

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The Office of the National Coordinator for Health IT (ONC) has released an implementation plan to Congress for the provisions of the HITECH Act within the American Recovery and Reinvestment Act (ARRA).

As far as its funding, ONC said the $2 billion that the office received under the ARRA will be disseminated to privacy and security efforts (about $24.29 million), the National Institute of Standards and Technology (NIST) (about $20 million) and regional health IT exchanges (about $300 million), which leaves about $1.66 billion still unspecified.

"This initiative will be an important part of health reform as health professionals and healthcare institutions, both public and private, will be enabled to harness the full potential of digital technology to prevent and treat illnesses and to improve health," ONC said. The office also noted that it "must meet tight deadlines created by statutory requirements of the law while assuring that ONC's decisions and actions support the law's fundamental, long-term purposes: improving health and healthcare through the best possible applications of health IT."

For the privacy and security spending plan, the Department of Health & Human Services (HHS) will implement time-sensitive, mandatory regulatory and enforcement requirements, providing contract assistance to meet statutory deadlines requiring promulgation of a variety of regulations and guidance, conduct multiple studies, and submit Congressional reports. In addition, it will enhance enforcement of the HIPAA Privacy and Security Rules by carrying out changes to the existing HIPAA complaint investigation and enforcement scheme.

The funding will allow the Centers for Medicare & 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 office said that HHS will transfer $20 million to NIST for continued work on advancing healthcare information integration through activities such as technical standards analysis and establishment of conformance testing infrastructure.

As of Dec. 31, HHS shall adopt and publish an initial set of standards, implementation specifications and certification criteria. The rulemaking for this initial set of standards, implementation specifications and certification criteria may be issued on an interim, final basis.

The ONC will develop a draft update, receive input from stakeholders, review the impact on other projects, adjust the operating plan and publish a strategic plan on the HHS Web site. Strategic planning expertise will be engaged utilizing competitive contract awards.

In defining "Meaningful Use of an EHR," the ARRA authorized 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.

Through the revision of the strategic plan, ONC will revise existing and develop additional performance measures that will more specifically support the individual programs funded with Recovery Act dollars. These measures will be tied to the goals and objectives of the revised Federal Health IT Strategic Plan and will, on a more granular level, gauge progress toward the intended outcomes of each program.

Although current measures are reported annually, ARRA-specific measures are under development and will be reported quarterly. HHS is working to develop cross-cutting outcome measures for health IT activities across the department. Initial outcome measures will be developed by Dec. 1. Some of the new measures will be reported quarterly to help HHS track progress toward the program's goals and objectives.

To view the entire ONC plan, visit http://www.hhs.gov/recovery/reports/plans/onc_hit.pdf.