Surescripts limited to EHR Modules of E-Prescribing, Privacy and Security
Here’s the listing found on ONC Web site on 12/29/2010 without further explanation. Surescripts is the first ATCB with this focused scope.
Surescripts LLC – Arlington, VA
Date of authorization: December 23, 2010.
Scope of authorization: EHR Modules: E-Prescribing, Privacy and Security
Regional Extension Centers Apply for Supplemental Funds
to Support CAHs and Rural Hospitals
from Office of National Coordinator for Health IT
REC Applications Due January 12, 2011
According to a December 28, 2010 ONC announcement, Regional Extension Centers, which support the process of achieving ‘Meaningful Use’ for eligible professionals, Critical Access Hospitals, Community Health Centers and Rural Health Clinics, may be able to receive supplemental funds to bring total to $18,000 per CAHs or Rural Hospitals under 50 beds per facility.
Posted December 28, 2010 on ONC Site
Synopsis: “This supplement will be available to recipients of the REC awards and is intended to ensure the provision of services to CAHs and Rural Hospitals in the REC’s service area. This award will be supplemental to the REC’s existing award, and the plans, metrics and reporting requirements will be included in the REC’s cooperative agreement. It is anticipated that each REC will need a total of $18,000 per CAH and Rural Hospital that it supports through this program, beyond the funding awarded in the base REC grant. RECs in Group A will be awarded $18,000/eligible CAH and Rural Hospital approved for funding. RECs in Group B will be awarded $6,000/previously approved CAH and Rural Hospital to bring the total amount of CAH/Rural Hospital supplemental funding from $12,000/hospital to $18,000/hospital. The supplemental funds will be used to ensure the delivery of the support services for CAH and Rural Hospitals and will be tied to the same milestones that are identified in the original REC FOA (EP-HIT-09-003). As with other funding milestones identified in the original FOA, recipients will be required to use the customer relationship management tool to help in meeting the milestones associated with this project.”
Key Links:
ONC Funding Announcement
Funding Announcement PDF
List of Eligible Hospitals [XLS – 175 KB]
Grants.gov Announcement and documents
Supplemental Funding Opportunity for Regional Extension Centers to assist eligible Critical Access Hospitals (CAH) and Rural Hospitals in adopting electronic health records and using them in a meaningful way
Excerpted from Funding Announcement Dec 28, 2010:
After the initial REC awards were made, the RECs recognized the challenges of serving CAH and Rural Hospitals were significant and therefore required greater resources than were provided. ONC recognized the unique needs of these hospitals and funded this project as a supplement to the REC funding (Funding Opportunity Number: EP-HIT-09-003). Supplemental funding can only be made available to entities with existing REC cooperative agreement awards. The purpose of the supplement was to ensure the provision of services to Critical Access Hospitals (CAH) and Rural Hospitals already defined within the scope of the cooperative agreements funded under FOA No. EP-HIT-09-003, as CAHs and Rural Hospitals are vital components of the rural health care system in the United States. These hospitals were included on the priority list for the RECs. The intent of the CAH/Rural Hospital Project is to provide additional support for staffing and expertise to assist rural CAHs and Rural Hospitals with less than 50 beds in selecting and implementing meaningful electronic health record (EHR) systems. These additional staff will work in coordination with other REC staff that will be supporting the primary care providers in the REC Service Areas.
The original cooperative agreement award was comprised of a four year project period, consisting of two budget periods. The first budget period (years 1 and 2) had a 90/10 cost share requirement and the second budget period (years 3 and 4) had a 10/90 cost share requirement. For the first budget period the grantee was responsible for contributing 1 dollar for every 9 federal dollars. For the second budget period, the grantee was responsible for contributing 9 dollars for every 1 dollar of federal funds.
In December 2010, the Secretary approved additional changes to the REC program under the authority of the cost-sharing waiver per the HITECH Act, stating that “The Secretary may provide financial support to any regional center created under this subsection for a period not to exceed four years. The Secretary may not provide more than 50 percent of the capital and annual operating and maintenance funds required to create and maintain such a center, except in an instance of national economic conditions which would render this cost share requirement detrimental to the program and upon notification to Congress as to the justification to waive the cost-share requirement.” This waiver provided changes to the REC program timeline and cost-sharing requirements. The timeline was modified to lengthen the first budget period from two years to four years. The cost-sharing requirement will now reflect a 90/10 federal/grantee cost share for all four years with the execution of a revised Notice of Grant Award (NGA).
As stated in original FOA, a positive biennial evaluation will be required for grantees to continue work in years 3 and 4 of the grant; this requirement is unchanged by the December 2010 waiver. The scope of work of the REC program also remains unchanged.
The purpose of this supplement is to further ensure the provision of services to Critical Access Hospitals (CAH) and Rural Hospitals, as described above and will make available funding to the following:
Group A: Regional Extension Centers which did not apply for supplement funding under the first supplemental funding announcement or were not funded under the first supplemental funding opportunity announcement.
Group B: Regional Extension Centers which did receive supplemental funding, and are applying for an additional $6,000 per eligible Critical Access Hospital (CAH) and Rural Hospital already defined within the scope of its cooperative agreement funded under FOA No. 2010-ONC-REC-S.
Scope of Services
Each applicant has already developed a plan for supporting priority setting (including providers at CAHs and Rural Hospitals) primary care providers in their service area to achieve meaningful use of an EHR system as part of their original application. This supplement is designed to provide support to the RECs, to ensure they can provide assistance to CAH and Rural Hospitals in their service area. In their original application, RECs stated that they were planning to work with CAH and Rural Hospitals. However, it was made known that the RECs may not have sufficient resources to carry out this endeavor.
For Group A, each funded REC will plan and implement the outreach, education, and technical assistance programs necessary to meet the objective of assisting CAHs and Rural Hospitals with less than 50 beds in its geographic service area to improve the quality and value of care they furnish by attaining or exceeding meaningful use criteria established by the Secretary of the Department of Health and Human Services (HHS). On-site technical assistance will be a key service. Selected RECs will modify their operating plans that were approved upon initial award to include specific plans for the CAH and Rural Hospital projects and will report their activities through the quarterly reporting process.
Group B will be required to modify their current operating plans, that were revised and approved per the first round of the Supplement Funding Opportunity Announcement and modify their plan to account for the additional funds ($6,000 per CAH and Rural Hospital) to further meet the objectives of assisting CAHs and Rural Hospitals with less than 50 beds in its geographic service area to improve the quality and value of care they furnish by attaining or exceeding meaningful use criteria established by the Secretary of the Department of Health and Human Services (HHS).
RECs are expected to work with both CAHs and Rural Hospitals who have not yet adopted EHR systems, and those with existing EHR systems, to assist them in achieving meaningful use of certified EHR technology. The milestones for this work will be the same as those identified in the original REC FOA (Funding Opportunity Number: EP-HIT-09-003); funds are for direct assistance only.
Subject to the limitations of eligible applicants described below in Section III, there are two types of CAHs and Rural Hospital organizations that are eligible for support through this application: (1) acute care hospitals (as defined in the SSA Section 1886(d)) with 50 or fewer beds located in a rural area and (2) a critical access hospital as defined in the SSA Section 1820(c) of the Social Security Act.
2010 ONC Update Meeting: Advancing the Dialogue on Health IT
Monday, December 27th, 2010 | Posted by: Dr. David Blumenthal on ONC’s Health IT Buzz blog and republished here by e-Healthcare Marketing.
Thank you to everyone who participated in the 2010 ONC Update on December 14-15, 2010 where we had the opportunity to discuss ONC’s strategies and programs, hear about your experiences in the field, assess progress to date, and get caught up on HITECH’s implementation. Video-recordings of the webcast are now available through the ONC website at http://healthit.hhs.gov/ONCMeeting2010.
The 2010 ONC Update was held in conjunction with 2010 ONC Grantee Meeting which brought together for the first time the awardees of all of the ONC programs , including the Beacon Communities Program, Regional Extension Center Program, SHARP Program, State Health Information Exchange Program, and the many Workforce Development Programs.
This year, significant strides were made in health information technology. And for us, information technology has always been a means to an end, the end of improving health, improving the health system, making the lives of our fellow Americans better, making our nation’s health professionals and institutions able to live up to their aspirations, empowering Americans to have and take control of their own health and lives. These are the reasons why the Congress and the President enacted the HITECH Act and the reason that the Office of the National Coordinator exists today.
But, of course, there are many organizations and groups that have those high aspirations. Our unique contribution comes from a core insight that good intentions have to be powered by strong capabilities. And science and technology have created for us an enormously powerful new set of tools in the form of health information technology.
We are here to make sure that those tools are used fully to realize our collective aspirations. Information is the lifeblood of medicine. As health professionals and institutions, we are only as good as the information we have about the patients that we care for. Health IT is destined to be the circulatory system for that information in the decades to come.
The last several months have been a whirlwind of activity. And it is easy to forget how much we’ve accomplished. We established the meaningful use framework, one that I think is unprecedented in the history of electronic health information systems. No other country has laid out a similar framework for what can and should be accomplished using health information technology. And on January 3, the Centers for Medicare & Medicaid Services will launch the registration process for those who wish to participate in the Medicare and Medicaid EHR Incentive Programs.
We’ve issued a standards and certification regulation. As of this week, we have five certifying bodies that are available to certify electronic health records. They’ve certified more than 200 records and modules in the several months since they’ve been in existence.
Regional extension centers – 62 of them are working hard to provide hands-on assistance to those providers that need the most help in making this transition. As of this week, 30,000 physicians have already enrolled in these extension programs across the United States.
The State Health Information Exchange Program has provided 56 states and territories with planning grants. More than 20 of these states and territories have approved implementation plans, and new implementation plans are being approved every day.
Seventeen Beacon Communities are now in place. They didn’t exist a year ago. They are paving the way toward real improvements in health and health care in the communities they serve, leveraging health information technology. The SHARP Program is tackling new challenges through research and development.
And ONC’s Workforce Development Programs are preparing a whole new workforce and creating new jobs to support the transformation of our health care system through the use of information technology. To date, we have seen almost 2,300 new enrollees in community college programs and close to 400 in University‑based Training Programs focused on health information technology. And we are well on our way in these very early stages toward meeting that target of 10,000 new health professionals trained annually during the lifetime of the program.
In addition to our grants, we have dozens of contracts that are supporting programs like the Nationwide Health Information Network. And our Health IT Policy Committee and Health IT Standards Committee continue to provide enormously valuable guidance on the many policies and standards that are needed to support execution against our mission.
All of these efforts not only play a critical role in our strategy related to the improvement of health and health care through information technology, but also provide the foundation for health systems change and upcoming reforms in how we deliver and pay for care.
As we look to 2011, there will be many challenges. Driving change is hard. And it takes leadership, commitment and the ability to move forward – despite the many obstacles that each of you will encounter. I hope your sense of contributing something unique to health care and the American people – for most certainly you are – balances the incredibly hard work that you are undertaking. Someday you will look back and realize that you were present at the creation of something big.
Thanks again, and we look forward to our continued collaboration in the new year.
###To comment directly on ONC’s Health IT Buzz Blog, click here.
See Blumenthal Letter #22 on e-Healthcare Marketing.
Registration for EHR Incentive Programs
Starts January 3, 2011: Are You Ready?
Dr. David Blumenthal
A Message from Dr. David Blumenthal, the National Coordinator for Health Information Technology
December 27, 2010
Published by ONC on 12/27/2010 and republished here.
The New Year is just around the corner, and so is another milestone in our nation’s work to improve health care through health information technology. Starting on January 3, 2011, eligible health care professionals, hospitals, and critical access hospitals may register to participate in the Medicare and Medicaid EHR Incentive Programs.
This is an auspicious time. Nearly two years ago, the Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009, was signed into law. Since then Department of Health and Human Services (HHS) agencies like the Office of the National Coordinator for Health Information Technology (ONC), the Centers for Medicare & Medicaid Services (CMS), the Office for Civil Rights (OCR), and others have implemented HITECH policies and programs to help providers adopt and achieve meaningful use of certified electronic health record technology and ensure that electronic health information remains private and secure.
[See Blumenthal's review of 2010, originally posted on ONC's Health IT Buzz blog.]
Why Become a Meaningful User?
Qualify for financial incentives from the federal government
Eligible professionals who demonstrate meaningful use have the opportunity to receive incentive payments through the Medicare and Medicaid EHR Incentive Programs—up to $44,000 from Medicare, or $63,750 from Medicaid. Under both Medicare and Medicaid, eligible hospitals may receive millions of dollars for implementing and meaningfully using certified EHR technology. Providers can get started now with the help of financial incentives from the federal government. If they wait, those incentives may not be available. And financial penalties are scheduled to take effect in five years.
Build a sustainable medical practice
The next generation of health care professionals will expect and demand that their own medical facility home have a state-of-the-art information system. Becoming a meaningful user of electronic health records will allow providers who are building their practices to recruit and retain talented young clinicians.
Improve the safety and quality of health care
The meaningful use of electronic health records will help health care providers and hospitals offer higher quality and safer care. By adopting electronic health records in a meaningful way, providers and hospitals can:
ONC and CMS: Here To Help
Registration for the incentive programs may be close at hand, but so is assistance. If you need help in registering for the Medicare and Medicaid EHR Incentive Programs or selecting a certified EHR system, ONC and CMS have resources and services to help you.
Connecting to Your Community
ONC also has other programs in place to help advance the meaningful use of certified EHR technology and health information exchange:
As 2010 comes to a close, we are well on our way as a nation to achieving the benefits of widespread adoption of EHRs. If you haven’t made any preparations to register to receive incentive payments, I encourage you to get started now. Resolve today to become a meaningful user in 2011.
Sincerely,
David Blumenthal, MD, MPP
National Coordinator for Health Information Technology
The Office of the National Coordinator for Health Information Technology (ONC) encourages you to share this information as we work together to enhance the quality, safety and value of care and the health of all Americans through the use of electronic health records and health information technology.
For more information and to receive regular updates from the Office of the National Coordinator for Health Information Technology, please subscribe to our Health IT News list.
New Jersey Health Information Technology Commission
January 6, 2011 3:00 to 5:00 pm
Meeting Agenda [PDF Version]
Auditorium, 1st Floor, Health and Agriculture Building,
369 S. Warren St
Trenton, NJ
1. Introductions
2. Colleen Woods, NJ Statewide Health Information Technology Coordinator:
Status on the State HIE Plan and key areas for the Commission’s direction
3. Alfred Campanella, Chair NJ HIT Commission: Chair’s reflections on Commission’s role and direction
4. Discussion on approach for stakeholder inputs (Consumers, Hospitals, Payors, etc.) and the role of Commission members
5. Housekeeping items: Meeting times, intra-Commission communication
6. Public Comments
Schedule of 2011 HIT Commission Meetings
First Thursday of each month.
January 6, 2011
February 3, 2011
March 3, 2011
April 7, 2011
May 5, 2011
May 5, 2011
June 2, 2011
July 7, 2011
August 4, 2011
September 1, 2011
October 6, 2011
November 3, 2011
December 1, 2011
| Registration for the Medicare and Medicaid EHR Incentive Programs opens on January 3, 2011. We encourage providers to register for the Medicare and/or Medicaid EHR Incentive Program(s) as soon as possible. You can register before you have a certified EHR. Register even if you do not have an enrollment record in PECOS.
A link to Registration will be available on CMS EHR Incentives Program site. Please Note: Although the Medicaid EHR Incentive Programs will begin January 3, 2011, not all states will be ready to participate on this date. Information on when registration will be available for Medicaid EHR Incentive Programs in specific States is posted at Medicaid State Information. “It is important for a dually-eligible hospital to select “Both Medicare and Medicaid” from the start of registration in order to maintain this option.” Hospitals and Eligible Professionals should read the notes below under the heading “What else do I need to know about registration?” [Registration for state Medicaid programs opens in the following states on January 3, 2011: * Alaska Registration for state Medicaid programs opens in the following states in February 2011: * California Other states likely will launch their Medicaid EHR Incentive Programs during the spring and summer of 2011.] e-Healthcare Marketing note: It’s important for hospitals and eligible professionals in ALL STATES to register when registration opens and not delay registering on the CMS site until their state Medicaid programs are ready. See further note below in red under the heading “What else do I need to know about registration? What can you do now for the Medicare and Medicaid EHR Incentive Programs? Make sure you have enrollment records in the appropriate systems. You’ll need:
CMS Identity and Access Management (I&A) User ID and Password
What information will you need when you register? Registering for the Medicare and Medicaid EHR Incentive Programs is easy when you have the following information available during the process: Eligible Professionals
Hospitals
NOTE: You do not have to provide information on the certified EHR technology you are using when you register. However, this information is required when you attest. What else do I need to know about registration? Hospitals: Hospitals that register only for the Medicaid program (or only the Medicare program) will not be able to manually change their registration (i.e., change to “Both Medicare and Medicaid” or from one program to the other) after a payment is initiated and this may cause significant delays in receiving a Medicare EHR incentive payment. Eligible Professionals: The Electronic Health Record (EHR) Information Center is open to assist the EHR Provider Community with inquiries. 8:30 a.m. – 4:30 p.m. (Central Time) Monday through Friday (except federal holidays) Submit an Inquiry to the EHR Information Center
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See e-Healthcare Marketing post for December 23, 2010 press release from ONC and CMS.
ELECTRONIC HEALTH RECORDS INCENTIVES REGISTRATION STARTS JAN. 3, 2011
CMS, ONC Outline Resources to Assist Eligible Providers
CMS Press Release on December 22, 2010
Today the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) announced the availability of registration for the Medicare and Medicaid electronic health record (EHR) incentive programs. CMS and ONC encouraged broad participation and outlined online and in-person resources that are in place to assist eligible professionals and eligible hospitals who wish to participate.
Beginning Jan. 3, 2011, registration will be available for eligible health care professionals and eligible hospitals who wish to participate in the Medicare EHR incentive program.
On January 3, registration in the Medicaid EHR Incentive Program will also be available in Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee, and Texas. In February, registration will open in California, Missouri, and North Dakota. Other states likely will launch their Medicaid EHR Incentive Programs during the spring and summer of 2011.
[See e-Healthcare Marketing post on registration directions.]
“With the start of registration, these landmark programs get underway, and patients, providers, and the nation can begin to enjoy the benefits of widespread adoption of electronic health records,” said CMS Administrator Donald Berwick, MD. “CMS has many resources available to help providers register and participate, and we look forward to working with eligible professionals and eligible hospitals to facilitate the process, beginning on January 3rd and going forward.”
“It’s time to get connected,” said David Blumenthal, MD, MPP, National Coordinator for Health Information Technology. “ONC and CMS have worked together over many months to prepare for the startup on January 3rd. ONC’s Certified HIT Product List includes more than 130 certified EHR systems or modules and is updated frequently. ONC also has hands-on assistance available across the country through 62 Regional Extension Centers
We look forward to continuing to work with CMS to assist eligible providers in 2011 and future years.”
Eligible professionals and eligible hospitals must register in order to participate in the Medicare and Medicaid EHR incentive programs. They can do so, starting Jan. 3, 2011, at a registration site maintained by CMS.
To prepare for registration, interested providers should first familiarize themselves with the incentive programs’ requirements by visiting CMS’ Official Web Site for the Medicare and Medicaid EHR Incentive Programs. The site provides general and detailed information on the programs, including tabs on the path to payment, eligibility, meaningful use, certified EHR technology, and frequently asked questions.
CMS announced the following key dates for the Medicare and Medicaid incentive programs’ first year:
Under the Health Information Technology for Economic and Clinical Health Act (HITECH), part of the American Recovery and Reinvestment Act of 2009, Medicare and Medicaid incentive payments will be available to eligible professionals, eligible hospitals, and critical access hospitals (CAHs) when they adopt certified EHR technology and successfully demonstrate “meaningful use” of the technology in ways that improve quality, safety, and effectiveness of patient-centered care.
Professionals who meet the eligibility requirements for both the Medicare and Medicaid EHR incentive programs must select which program they wish to participate in when they register. They cannot participate in both programs; however, after receiving payment, they may change their program selection once before 2015. Hospitals that are eligible for both programs can receive payments from both Medicare and Medicaid.
Some states will launch their Medicaid EHR incentive programs beginning Jan. 3, 2011, but most will launch their programs during the spring and summer. Eligible providers with questions about their state’s launch date should contact their state Medicaid agency. Eligible providers seeking to participate in the Medicaid programs must initiate registration at CMS’ registration site but must complete the process through an eligibility verification site maintained by their state Medicaid agency.
Under the EHR incentive programs, eligible professionals can receive as much as $44,000 over a five-year period through Medicare. For Medicaid, eligible professionals can receive as much as $63,750 over six years. Under both Medicare and Medicaid, eligible hospitals may receive millions of dollars for implementing and meaningfully using certified EHR technology.
“The benefits of EHRs are widely recognized, and support for the incentive programs is strong in the health care field and among policymakers,” Dr. Berwick said. “The changeover from paper to electronic records will be challenging for clinicians and hospitals, but CMS and ONC have taken steps to ease the transition. We’ve provided flexibility in meeting the meaningful use requirements, both agencies have conducted extensive outreach, and we have the resources in place to help providers acquire certified EHR technology and meet the programs’ requirements. Immediate registration is not required, but we encourage eligible providers to sign up as soon as they have certified EHR technology and are prepared to participate. We are ready to help.”
# # # # # # #
VERY IMPORTANT NOTICE FROM CMS WEB SITE
Hospitals:
Hospitals that are eligible for EHR incentive payments under both Medicare and Medicaid should select “Both Medicare and Medicaid” during the registration process, even if they plan to apply only for a Medicaid EHR incentive payment by adopting, implementing, or upgrading certified EHR technology. Dually-eligible hospitals can then attest through CMS for their Medicare EHR incentive payment at a later date, if they so desire. It is important for a dually-eligible hospital to select “Both Medicare and Medicaid” from the start of registration in order to maintain this option.
Hospitals that register only for the Medicaid program (or only the Medicare program) will not be able to manually change their registration (i.e., change to “Both Medicare and Medicaid” or from one program to the other) after a payment is initiated and this may cause significant delays in receiving a Medicare EHR incentive payment.
Eligible Professionals:
Eligible professionals eligible for both the Medicare and Medicaid EHR Incentive Programs must choose which incentive program they wish to participate in when they register. Before 2015, an eligible professional may switch programs only once after the first incentive payment is initiated. Most eligible professionals will maximize their incentive payments by participating in the Medicaid EHR Incentive Program.
The Electronic Health Record (EHR) Information Center is open to assist the EHR Provider Community with inquiries.
Hours of operation are:
8:30 a.m. – 4:30 p.m. (Central Time) Monday through Friday (except federal holidays)
1-888-734-6433 (primary number) or 888-734-6563 (TTY number)
AJMC Publishes Health Information Technology Special Issue Online Dec 20, 2010
“Featuring scholarly articles and perspectives from policymakers, payers, providers, pharmaceutical companies, health IT vendors, health services researchers, patients, and medical educators, this [December 2010 special] issue of The American Journal of Managed Care is a reflection” of “the dramatic growth of interest in the potential for HIT to improve health and healthcare delivery,” writes Sachin H. Jain, MD, MBA and David Blumenthal, MD, MPP in their introductory article titled “Health Information Technology Is Leading Multisector Health System Transformation.” Both Jain and Blumenthal are with the Office of the National Coordinator for Health Information Technology.
Authors of 23 Articles in Special Issue
Sachin H. Jain, MD, MBA; and, David Blumenthal, MD, MPP; Cynthia L. Bero, MPH; and Thomas H. Lee, MD; Aaron McKethan, PhD; and Craig Brammer; John Glaser, PhD; Pete Stark; Newt Gingrich, PhD, MA; and Malik Hasan, MD; James N. Ciriello, MS; and Nalin Kulatilaka, PhD, MS; Seth B. Cohen, MBA, MPA; Kurt D. Grote, MD; Wayne E. Pietraszek, MBA; and Francois Laflamme, MBA; Amol S. Navathe, MD, PhD; and Patrick H. Conway, MD, MSc; Reed V. Tuckson, MD; Denenn Vojta, MD; and Andrew M. Slavitt, MBA; Marc M. Triola, MD; Erica Friedman, MD; Christopher Cimino, MD; Enid M. Geyer, MLS, MBA; Jo Wiederhorn, MSW; and Crystal Mainiero; Nancy L. Davis, PhD; Lloyd Myers, RPh; and Zachary E. Myers; Bryant A. Adibe, BS; and Sachin H. Jain, MD, MBA; Spencer S. Jones, PhD; John L. Adams, PhD; Eric C. Schneider, MD; Jeanne S. Ringel, PhD; and Elizabeth A. McGlynn, PhD; Jeffrey L. Schnipper, MD, MPH; Jeffrey A. Linder, MD, MPH; Matvey B. Palchuk, MD, MS; D. Tony Yu, MD; Kerry E. McColgan, BA; Lynn A. Volk, MHS; Ruslana Tsurikova, MA; Andrea J. Melnikas, BA; Jonathan S. Einbinder, MD, MBA; and Blackford Middleton, MD, MPH, MS;Alexander S. Misono, BA; Sarah L. Cutrona, MD, MPH; Niteesh K. Choudhry, MD, PhD; Michael A. Fischer, MD, MS; Margaret R. Stedman, PhD; Joshua N. Liberman, PhD; Troyen A. Brennan, MD, JD; Sachin H. Jain, MD, MBA; and William H. Shrank, MD, MSHS; Amir Dan Rubin, MBA, MHSA; and Virginia A. McFerran, MA; Fredric E. Blavin, MS; Melinda J. Beeuwkes Buntin, PhD; and Charles P. Friedman, PhD Robert D. Hill, PhD; Marilyn K. Luptak, PhD, MSW; Randall W. Rupper, MD, MPH; Byron Bair, MD; Cherie Peterson, RN, MS; Nancy Dailey, MSN, RN-BC; and Bret L. Hicken, PhD, MSPH; Jeffrey A. Linder, MD, MPH; Jeffrey L. Schnipper, MD, MPH; Ruslana Tsurikova, Msc, MA; D. Tony Yu, MD, MPH; Lynn A. Volk, MHS; Andrea J. Melnikas, MPH; Matvey B. Palchuk, MD, MS; Maya Olsha-Yehiav, MS; and Blackford Middleton, MD, MPH, MSc; Emily Ruth Maxson, BS; Melinda J. Beeuwkes Buntin, PhD; and Farzad Mostashari, MD, ScM; Daniel C. Armijo, MHSA; Eric J. Lammers, MPP; and Dean G. Smith, PhD; Katlyn L. Nemani, BA.
Look for an upcoming post on e-Healthcare Marketing reviewing this special issue of AJMC.
Affirming Flexibility…With Certified EHR Systems
Thursday, December 23rd, 2010 | Posted by: Dr. David Blumenthal on ONC Health IT Buzz blog and republished here by e-Healthcare Marketing
Today on our FAQ page, we are posting a revised Question and Answer regarding an issue that has recently caused confusion in our meaningful use regulations: namely, the flexibility that providers have to defer performance on some Stage 1 meaningful use objectives; and how that squares with the requirement that providers must nonetheless possess fully-certified EHR systems.
The new FAQ is meant to clarify this two-part requirement. But we should make it equally clear that our policy has not changed:
To understand this two-part approach, we need to look back to the development of the meaningful use regulations. From the beginning, this process was aimed at achieving the right balance – a balance between the need to achieve effective and rapid adoption of EHRs throughout the United States; and at the same time to be realistic about the challenges facing providers on the road to meaningful use.
In our final regulations, I believe HHS achieved the needed balance:
Why did we require that EHRs be certified as capable of meeting all of the certification criteria for meaningful use, even though we allowed flexibility concerning which criteria providers actually had to meet? There were several reasons.
First, our regulation stated that in Stage 2 of Meaningful Use, we will require that providers meet all the requirements laid out in Stage 1, including all 10 of objectives on the options menu. Having records capable of meeting all 10 objectives allows providers to get a head start on Stage 2 of meaningful use.
Second, we expect that some providers may try and fail to meet meaningful use objectives on one or more of the menu criteria. If their records are not capable of meeting the other optional objectives, they may be unable to obtain and implement the capabilities they lack in time to qualify for meaningful use. Thus, the requirement that certified EHRs possess the capability to meet all requirements actually gives providers the flexibility to experiment with multiple approaches to meeting meaningful use– and guarantees that if they fall short, they will not be left high and dry. This flexibility is only possible when the provider has access to certified technology for all Stage 1 functions.
The details of these requirements can be found in the new FAQ , and I invite you to read and comment. I hope it will be clear that these two elements are not in conflict, but rather represent the balance that has characterized the evolution of the meaningful use process. Finally, I hope it will be clear that there has been no change in the guarantee of provider flexibility during Stage 1.
To achieve EHR-based health care, we need to build a strong technology foundation. But at the same time, we need to recognize that providers have varying circumstances and different needs, and we seek to accommodate those differences as we support the transition to EHRs. In that spirit, we are delivering on the promise in our final regulations to give providers the flexibility they require to succeed in adoption and meaningful use of EHRs.
Supplemental Challenge Funding to State HIE Programs
FAQs, Slides, Audio from Technical Assistance Conference Call
Excerpted from ONC sites on Dec 23, 2010
FAQs
PDF Version
1. How do I determine if my organization is an eligible applicant for this funding opportunity?
Current direct award recipients of the State HIE Cooperative Agreement program are eligible to apply for this funding opportunity. To determine if your organization is the eligible entity in your state, review the most recent Notice of Grant Award for the State HIE Cooperative Agreement Program. The direct award recipient is listed in Box 11 “Recipient Organization.” There are 56 eligible organizations for this funding opportunity.
2. Can we apply for funding to support an unfunded project we discussed in our State Plan submitted under the State HIE Cooperative Agreement program?
Funds under this announcement cannot be used to fund activities already presented in the Strategic and Operational Plans and funded as part of the scope of work under the State HIE Cooperative Agreement. Funds cannot be used to supplant or replace current public or private funding of projects. Funds also cannot be used to supplant ongoing or usual activities of any organization involved in the project. However, if a project was presented in the State Plan but clearly not funded with public or private monies and is not part of ongoing scope of work of an affiliated organization, it may be submitted as part of a project under this funding opportunity.
3. As part of our proposed project, we will contract with a vendor to develop software for use by providers in the project. Please clarify what is meant by “Any IT system components (e.g., software, data models, etc.) developed by the awardees under this funding opportunity will be made available to any state.” Does this mean any IT development must be open source?
No, IT development does not have to be open source. The purpose of this program is to fund innovative technology development and approaches in pilot sites that will then be shared, reused, and leveraged by other states and communities to increase nationwide interoperability. Anything developed with funds under this cooperative agreement must be accessible and usable outside of the pilot site. Successful awardees must demonstrate how the tools, systems, or models developed under this cooperative agreement will be easily adapted and implemented beyond the pilot scope of work.
4. Can we propose a project with a geographic area that overlaps with a Beacon awardee?
While nothing in this funding announcement prohibits an overlap in targeted geographic areas, the scope of work must be different for both projects; funds under this announcement cannot be used to supplant or replace current public or private funding.
5. How should the budget documentation be presented in the application?
Applicants are required to submit a one-year budget for each year of the project period. Please remember that the challenge grants period of performance (project period) ends at the
same time as the current cooperative agreement. Therefore, budgets should only be submitted for the remaining three years in the cooperative agreement since the project periods will be married. Applicants are suggested to use the format included as Appendix A of the Funding Opportunity Announcement. Applicants are also encouraged to refer to Appendix J of the State HIE Cooperative Agreement FOA, which provides an example of the level of detail sought.
A combined multi-year Budget Narrative/Justification, as well as a detailed Budget Narrative/Justification for each year of potential grant funding is also required. Instructions were provided in Appendix I of the State HIE Cooperative Agreement FOA that pertain to completing the SF 424.
6. Can the eligible entity apply for this funding opportunity and then contract or subgrant the substantive work to an outside entity?
The direct award recipient must have direct oversight and accountability for the project. When preparing the budget, the six contractual elements required to be submitted when subawarding a substantial portion of the programmatic work must be included. These are:
I. Name of Contractor: Who is the contractor
II. Method of Selection: ? Identify the name of the proposed contractor and indicate whether the contract is with an institution or organization.
How was the contractor selected
III. Period of Performance: ? State whether the contract is sole source or competitive bid. If an organization is the sole source for the contract, include an explanation as to why this institution is the only able to perform contract services.
How long is the contract period
IV. Scope of Work: ? Specify the beginning and ending dates of the contract.
What will the contractor do
V. Method of Accountability: ? Describe in outcome terms the specific services/tasks to be performed by the contractor as related to the accomplishment of program objectives. Deliverables should be clearly defined.
How will the contractor be monitored
VI. Itemized budget and justification: Provide an itemized budget with appropriate justification. If applicable, include any indirect cost paid under the contract and indirect cost used. Provide a copy of the negotiated indirect cost rate agreement. ? Describe how the progress and performance of the contractor will be monitored during and on close of the contract period. Identify who will be responsible for supervising the contract.
7. Can my state’s eligible entity request funding for more than one challenge theme?
Eligible entities may submit one application per challenge theme; therefore, no more than five applications are permitted from each eligible entity. Each application must clearly indicate the challenge theme addressed. Approximately 10 awards will be made; it is possible for an eligible entity to receive more than one award.
8. Can letters of commitment to the State Health Information Exchange Cooperative Agreement be used to demonstrate commitment to this initiative?
Yes. However, applicants are strongly encouraged to include letters of commitment from key program partners and stakeholders that are specific to the project proposed in the application.
9. Some staff supported under the State HIE Cooperative Agreement would be proposed in our application to support the challenge project. Is that allowable? Can we rebudget our State HIE Cooperative Agreement to reflect the staffing shifts?
Applicants are advised that the scope of work and budget for this application must be separate from the funded scope of work in the State Health Information Exchange cooperative agreement. In the event that staff may overlap, please note that ONC will develop a process for successful applicants to finalize the scope of work, staffing, and budget to ensure that successful performance of the Health Information Exchange cooperative agreement is not jeopardized and to assure that funds are not supplanted.
PDF of Funding Announcement
Health Information Exchange Challenge Program Funding Opportunity Announcement
See previous e-Healthcare Marketing post on Challenge Program.
