Category Archives: States

ONC: CAHs and Rural Hospitals to gain add’l support from RECs–Jan 12 Deadline

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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

  • Funding Opportunity Number: 2010-ONC-REC-S-01
  • Closing Date for Applications: January 12, 2011, 11:59 p.m. EST
  • Estimated Total Program Funding: $12,228,000

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.

Blumenthal Letter #22: Ready for Jan 3 EHR Incentives Registration?

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Registration for EHR Incentive Programs
Starts January 3, 2011: Are You Ready?

Dr. David Blumenthal

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:

  • See the whole picture. All of a patient’s health information—medical history, diagnoses, medications, lab and test results—is in one place. Providers don’t have to settle for a snapshot when they can have the entire album.
  • Coordinate care. Providers involved in a patient’s care can access, enter, and share information in an electronic health record.
  • Make better decisions. With more comprehensive health information at their fingertips, providers can make better testing, diagnostic, and treatment decisions.
  • Save time and money. Providers who have implemented electronic health records say they spend less time searching for paper charts, transcribing, calling labs or pharmacies, reporting, and fixing coding errors.

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.

  • The Medicare and Medicaid EHR Incentive Programs website contains educational resources and fact sheets with information to help eligible professionals and hospitals adopt, implement, and upgrade certified EHR technology and demonstrate meaningful use to receive EHR incentive payments.
  • Regional Extension Centers, which cover every region of the country, provide on-the-ground technical assistance to health care providers working to adopt and meaningfully use certified EHR technology.
  • The Health IT Workforce Development Program prepares skilled workers for new jobs in health IT.

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.

Directions for CMS EHR Incentives Registration

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Registration and Attestation Begins January 3, 2011
Program Directions
Excerpted from CMS EHR Incentives Program on 12/26/2010.

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
* Iowa
* Kentucky
* Louisiana
* Oklahoma
* Michigan
* Mississippi
* North Carolina
* South Carolina
* Tennessee
* Texas

Registration for state Medicaid programs opens in the following states in February 2011:

* California
* Missouri
* North Dakota

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:

  • A National Provider Identifier (NPI)
    • All eligible professionals, eligible hospitals, and critical access hospitals (CAHs) must have a National Provider Identifier (NPI) to participate in the Medicare and Medicaid EHR Incentive Programs.
  • An enrollment record in the Provider Enrollment, Chain and Ownership System (PECOS)
    • All eligible hospitals and Medicare eligible professionals must have an enrollment record in PECOS to participate in the EHR Incentive Programs. (Note: Eligible professionals who are only participating in the Medicaid EHR Incentive Program are not required to be enrolled in PECOS.)
    • If you do not have an enrollment record in PECOS, you should still register for the Medicare and Medicaid EHR Incentive Programs.

CMS Identity and Access Management (I&A) User ID and Password

  • Eligible Professionals:
    • Eligible professionals can use the same User ID and Password they use for the National Plan and Provider Enumeration System (NPPES). This is also the same User ID and Password that is used to access PECOS.
    • If you do not have an active User ID and Password for NPPES or PECOS, request them via Identity & Access Management. You will need your type 2 NPI, your Taxpayer Identification Number (TIN), and your address from IRS Form CP-575. You will also need to mail a copy of IRS Form CP-575 as directed.
  • Hospitals/Critical Access Hospitals:
    • Authorized Officials can use the same User ID and Password they use to access PECOS.
    • If you do not have an Authorized Official with access to PECOS, request a User ID and Password via Identity & Access Management. You will need your type 2 NPI, your Taxpayer Identification Number (TIN), and your address from the IRS Form CP-575. You will need to mail a copy of the IRS Form CP-575 as directed.
    • Additional hospital staff will need to request access to the “EHR Incentive Programs” application through Identity & Access Management and be approved by the Hospital’s Authorized Official.

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

  • National Provider Identifier (NPI).
  • National Plan and Provider Enumeration System (NPPES) User ID and Password.
  • Payee Tax Identification Number (if you are reassigning your benefits).
  • Payee National Provider Identifier (NPI)(if you are reassigning your benefits).

Hospitals

  • CMS Identity and Access Management (I&A) User ID and Password.
  • CMS Certification Number (CCN).
  • National Provider Identifier (NPI).
  • Hospital Tax Identification Number.

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 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)

Submit an Inquiry to the EHR Information Center

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Downloads
Medicare EP PECOS Notification [PDF, 119KB]
Hospital PECOS Notification [PDF, 160KB]
Related Links Inside CMS
Frequently Asked Questions (FAQs)
Excerpted from CMS Page Modified on 12/23/2010 8:41:41 AM

See e-Healthcare Marketing post for December 23, 2010 press release from ONC and CMS.

EHR INCENTIVES REGISTRATION STARTS JAN. 3, 2011

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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:

  • Jan. 3, 2011 – Registration for the Medicare EHR incentive program begins.
  • Jan. 3, 2011 –States that are ready may launch their incentive programs for Medicaid providers.
  • January 2011 – Some state agencies begin issuing Medicaid EHR incentive payments.
  • April 2011 – Attestation for the Medicare EHR incentive program begins.
  • May 2011 – Issuing of Medicare EHR incentive payments expected to begin.
  • July 3, 2011 – Last day for eligible hospitals to begin their 90-day reporting period to demonstrate meaningful use for the Medicare EHR incentive program for federal FY 2011.
  • Sept. 30, 2011 – Federal FY 2011 payment year ends at midnight for eligible hospitals and critical access hospitals (CAHs).
  • Oct. 3, 2011 – Last day for eligible professionals to begin their 90-day reporting period for calendar year 2011 to demonstrate meaningful use for the Medicare EHR incentive program.
  • Nov. 30, 2011 – Last day for eligible hospitals and CAHs to register and attest to receive an incentive payment for federal fiscal year 2011.
  • Dec. 31, 2011 – Calendar 2011 payment year ends for eligible professionals.

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)

Submit an Inquiry to the EHR Information Center
###

See e-Healthcare Marketing post on registration directions.

Health IT Special Issue of The American Journal of Managed Care: Dec 2010

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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.

Supplemental Challenge Funding to State HIE Programs: FAQs, Slides, Audio from Tech Assistance Call

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Supplemental Challenge Funding to State HIE  Programs
FAQs, Slides, Audio from Technical Assistance Conference Call
Excerpted from ONC sites on Dec 23, 2010

  • Closing Date for Applications from State HIEs: January 05, 2011 at 5:00 PM, EST
  • Estimated Total Program Funding: $16,296,562
    Technical Assistance Call
Supports awards in five challenge areas to enable nationwide health information exchange:
§Achieving health goals through health information exchange
§Improving long-term and post-acute care transitions
§Consumer-mediated information exchange
§Enabling enhanced query for patient care
§Fostering population-level analytics

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.

Colleen Woods Asks “Where are the NJ Healthcare Innovators?!!”

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From: Colleen Woods, NJ Health IT Coordinator
To: New Jersey Healthcare Innovators,
NJ Health IT Community
Re: Calling for Innovations for Supplemental ONC Funding
Date: Dec 21, 2010
High PriorityMost of you are aware that the Office of the National Coordinator issued a supplemental funding opportunity to the State Health Information Exchange Cooperative Agreement Program.  As required, on December 10th,2010,  I responded that New Jersey would apply for the supplemental funding, knowing that we have many exciting projects in place that could be advanced with just a bit of additional funds.

There are five challenge “themes” that the feds view as potential barriers to full national health information exchange. They are seeking innovative ideas/solutions from those of you who know healthcare delivery the best.  The themes are:
  • Achieving Health Goals through Health Information Exchange
  • Improving Long Term and Post Acute Care Transitions
  • Consumer Mediated Information Exchange
  • Enabling Advance Query for Patient Care
  • Fostering Distributed Population-Level Analytics

For more information please see a PDF of the  ONC’s funding announcement: http://goo.gl/oGc7Q

Or to see all the funding documents, go to Grants.gov:http://goo.gl/0dk3i

I know there are a lot of good ideas and projects already underway that would qualify for this funding opportunity. (Jeff, Becky, Jim, Tom, Dave, Tom, Linda, Lou, Judy, Neal, Al, Bob et al…..) , but the award requires a quick response.  Applications need to be sent to by the NJ State Coordinator’s Office ONC by January 5th, 2011. I would proud to submit any ideas you have that would meet the ONC challenge.  Please feel free to call me to discuss.

My best wishes to you and your families for a Happy Holiday Season!

Colleen

Colleen Woods
NJ Health IT Coordinator
Governor’s Office
(609)777-2609
colleen.woods@gov.state.nj.us

Synopsis of the Supplemental State HIE Challenge Program
“This funding announcement for the Health Information Exchange Challenge Program encourages breakthrough progress for nationwide health information exchange in five challenge areas identified as key needs since Federal and State governments began implementation of the HITECH Act. The awards will fund the development of technology and approaches that will be developed in pilot sites and then shared, reused, and leveraged by other states and communities to increase nationwide interoperability. The five themes include: 1. Achieving health goals through health information exchange 2. Improving long-term and post-acute care transitions 3. Giving patients access to their own health information 4. Developing tools and approaches to search for and share granular patient data (such as specific lab results for a given time period) 5. Fostering strategies for population-level analysis Awards will range between $1 million and $2 million each, and will be in the form of supplemental funding to State Health Information Exchange Cooperative Agreements, which have provided approximately half a billion dollars to states and State designated entities to enable health information exchange. Funding for this initiative is approximately $16 million which ONC anticipates will support 10 awards.”
–Synopsis from grants.gov

Illinois, Wisconsin, New Hampshire Plans Brings to 18 ONC’s Approved Strategic and Operational Plans

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Eighteen States/SDEs with Approved Strategic and Operational Plans

Excerpted from State HIE Toolkit 12/22/2010

Illinois announced that their plans were approved by ONC on Dec 21, 2010. With recent addtions of Wisconsin, New Hampshire, Idaho, North Carolina, Vermont, and Washington, this brings total to 18 the number of states with approved strategic and operational plans listed on ONC’s State HIE Toolkit. Approved plans include California, Delaware, Idaho, Illinois, Maine, Maryland, Michigan, Nebraska, New Mexico, North Carolina, South Carolina, Tennessee, Texas, Utah, Vermont, and Washington.

Illinois HIE Strategic and Operational Plan

Here are the links to Illinois’s approved plans from Illinois HIE site.

http://www.hie.illinois.gov/sop.html 

State HIE Toolkit Updated 12/21/2010

The list below represents the currently approved state specific strategic and operational plans for creating Health Information Exchange capacity. [Note: Several state plans have not yet been published. State of Washington’s original submission and ONC response are shown, but final plan has not yet been published. Most of the links go to PDF files.] While Illinois has been added to ONC’s State HIE Toolkit chart (not yet shown below),  links to Illinois plan have not yet been added on ONC site.

The list below represents the currently approved state specific strategic and operational plans for creating Health Information Exchange capacity.

State

Strategic /Operational Plans

and

State Summaries

 Entity Responsible for Grant Plan Approval Date
California

Strategic and Operational Plans

To view the documents separately click here (easier download)

 California Health and Human Services Agency 6/16/2010
Delaware  Pending Delaware Health Information Network 5/17/2010
Idaho  Pending Idaho Health Data Exchange 12/7/2010
Illinois  Pending Illinois Department of Healthcare and Family Services 12/20/2010
Maryland Strategic and Operational Plans The Maryland Department of Health and Mental Hygiene 5/14/2010
Michigan

Strategic and Operational Plans

Amendment 1

 Michigan Department of Health 11/29/2010
Nebraska Strategic and Operational Plans Nebraska Department of Administrative Services 11/5/2010
New Hampshire  Pending New Hampshire Department of Health and Human Services 12/10/2010
New Mexico Strategic and Operational Plans LCF Research, New Mexico 1/25/2010
North Carolina

Strategic and Operational Plans

State Summary

 North Carolina Department of State Treasurer 11/3/2010
Oregon  Pending State of Oregon 12/10/2010
South Carolina Strategic and Operational Plans South Carolina Department of Health & Human Services 8/30/2010
Tennessee

Strategic and Operational Plans

Gap Analysis

State Summary

 State of Tennessee 9/17/2010
Texas Strategic and Operational Plans Texas Health and Human Services Commission 11/3/2010
Utah Strategic and Operational Plans Utah Department of Health 5/12/2010
Vermont Strategic and Operational Plans Vermont Department of Human Services 10/26/2010
Washington  Pending Washington Health Care Authority 12/10/2010
Wisconsin  Pending Wisconsin Department of Health and Family Services 12/20/2010

See e-Healthcare Marketing post for 32 State Health Information Exchange Plans, last updated on November 21, 2010. The Nov 21 update still needs to be reviewed and revised based on plan revisions not yet captured in that post.

ONC’s Kendall blogs about ‘Regional Extension Centers Supporting EHR Adoption’

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Regional Extension Centers Supporting EHR Adoption
Tuesday, December 14th, 2010 | Posted by: Mat Kendall Director Office of Provider Adoption Support on ONC Health IT Buzz blog and republished here by e-Healthcare Marketing.

The Regional Extension Centers (RECs) located across the country play a critical role in advancing the use of health information technology (health IT). They are charged with guiding some 100,000 health care providers in their efforts to establish and meaningfully use electronic health records in their practices. They offer a variety of services including outreach and education, and on-the-ground assistance.

With a total of 62 RECs, we are in every area of the U.S. to assist health care providers in their transition to electronic health records. To ensure that these critical partners have the knowledge and tools they need to assist their area’s health care providers, leaders from ONC’s Office of Provider Adoption Support  spend a good deal of time on the road meeting with REC staff members.

So far we’ve held workshops and seminars on topics like meaningful use, privacy and security, vendor selection, and workforce development.  We’ve had the chance to participate in events where leaders from different RECs come together to network and share best practices.  And we’ve learned about new ways we can support our RECs in their mission to help health care providers adopt electronic health records.

We are now implementing several new initiatives as a result of what we’ve learned from our REC partners:

  • An interactive online community that houses a wealth of tools and resources for RECs to obtain strategic health IT support and exchange ideas
  • An Outreach, Education, and Marketing Guide to assist RECs in their outreach efforts
  • A Meaningful Use Vanguard (MUV) cohort to showcase and reward health care providers who are true health IT ambassadors
  • Outreach campaigns to assist RECs in their recruitment of participating health care providers
  • Partnering with EHR vendors to identify best practices for working together to meet the needs of providers

These initiatives are only the beginning.

Our RECs are in the field, actively recruiting and signing on providers to their services. To date, our RECs have enrolled over 28,000 providers and for the last 12 weeks, the RECs across the country have enrolled on average over 1,000 providers a week.   Some RECs, such as Mississippi and Maine have enrolled over 60% of their overall primary care provider target.  Others, such as Colorado, the California Health Information Partnership Service Organization, Massachusetts, North Carolina, New York City Washington/Idaho RECs have enrolled over 1,000 providers in the last few weeks.

We are looking forward to hearing more about the RECs and their accomplishments at the 2010 ONC Update Meeting, December 14-15, in Washington D.C. This meeting will be a great opportunity to continue our dialogue with the RECs and learn about other ways we can support them. We want to ensure that the RECs are fully equipped to help our nation’s health care providers become meaningful users of electronic health records.

To find out more about the REC program in general, visit healthit.hhs.gov/REC.
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To post comments directly on ONC Health IT Buzz blog post, please click here.

Meaningful Use Vanguard Program
To see an example at a state REC level of the Meaningful Use Vanguard Program launched November 15, 2010, see the “The West Virginia Regional HIT Extension Center (WVRHITEC) [which] has established a new physician-to-physician outreach and education program designed to assist and help foster more widespread adoption and use of electronic health record systems in West Virginia.” Click here.

Blumenthal Letter #21: 2010 ONC Update [and Welcome to 2010 ONC Conference]

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2010 ONC Update
Dr. David BlumenthalA Message from Dr. David Blumenthal, the National Coordinator for Health Information TechnologyDecember 10, 2010
Accessed from ONC site 12/13/2010.

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 other HHS agencies are dedicated to improving the nation’s health care through health information technology (health IT).

Since the Health Information Technology for Economic and Clinical Health (HITECH) Act was signed into law in February 2009, we have established a number of initiatives that will help make it possible for providers to achieve meaningful use and for Americans to benefit from electronic health records as part of a modernized, interconnected, and vastly improved system of care delivery.

This year alone, we have established a number of important policies and programs to help lay the foundation for providers to begin their journey toward meaningful use. These include: 

It’s been a busy year for health IT at HHS.

We are looking forward to discussing more about all of our HITECH initiatives to date, as well as our future activities, at the upcoming 2010 ONC Update Meeting on December 14 and 15.

Over the course of this two-day meeting, we are offering a number of sessions that will give participants a better understanding of the HITECH regulations and the role that HITECH plays in health system change and health care reform. Some session topics include:

  • HITECH programs that support providers in achieving meaningful use
  • How HITECH initiatives will promote consumer empowerment and public engagement
  • Privacy and security policies

Our panelists and invited speakers include HHS Secretary Kathleen Sebelius and leaders from CDC, CMS, OCR, ONC and organizations who have a stake in our work. We are excited about the opportunity to share information and ideas.

The plenary sessions at this meeting will be streamed through a live webcast. Details about the webcast are available on the ONC website: http://healthit.hhs.gov/ONCMeeting2010.

Thank you in advance for joining us at the 2010 ONC Update Meeting and for supporting our vision of a higher quality, safer, and more efficient health care system enabled by health information technology.

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  ONC’s Health IT News list.