ONC’s State HIE Toolkit: “Execution: The Discipline of Getting Things Done”
For the Office of National Coordinator for Health IT, 2010 and the ONC’s State HIE Toolkit are about “getting things done’” to quote the title of Larry Bossidy’s and Ram Charan’s 2002 business classic “Execution: The Discipline of Getting Things Done.”  

National Coordinator for Health IT  Dr. David Blumenthal spoke with reporters in a March 15, 2010 conference call about the final round of awards of  State HIE Cooperative Agreements to 16 remaining states, and said “As part of the grants, the Office of the National Coordinator for Health IT will give states guidance and technical assistance, essentially working ‘side by side with the states, looking at their plans and helping them to design and implement them,’” which was reported by Mary Mosquera of Government HealthIT. The State HIE Toolkit developed by AHIMA under the direction of ONC is part of the “side by side” relationship to which Blumenthal referred.

Excerpts from the State HIE Toolkit as of March 16, 2010:
http://statehieresources.org

“As a dynamic resource, the Toolkit will be regularly updated to reflect the ongoing experiences and needs of states as well as the growing body of lessons learned about what constitute “best practices” in statewide HIE.  Throughout the Toolkit are some examples from the field of state HIE development as it has been evolving to date.  However, information and examples from ONC approved strategic and operational plans and the latest updates on ONC Program guidance will be integrated into the Toolkit as it becomes available.”     http://statehieresources.org  

About the State HIE Toolkit
“The Toolkit addresses the five essential domains (i.e. governance, finance, technical infrastructure, business operations, and legal/policy) and also offers information related to general planning, grant management and other cross-cutting areas such as coordination with federal programs.” 

Toolkit Content Development
“Contributors to the Toolkit content include a collaborative team of experts with experience in the field, led by staff from the ONC funded State-level Consensus Project (SLHIE Project).  

“The Toolkit is inherently a “work in progress”, designed to be regularly updated to reflect the ongoing experiences and needs of states as well as the growing body of lessons learned about what constitute “best practices” in statewide planning and implementation.  

•Throughout the Toolkit are some examples from the field of state development as it has been evolving to date.  

•However, as it becomes available, information and examples from approved strategic and operational plans will be integrated into the Toolkit.  

•The Toolkit will continue to link to relevant Program documents as information becomes available from the Office of the National Coordinator (ONC).” 

Toolkit Organization & Updates
“The number of Toolkit modules will be expanded and all of the modules will be updated on a regular basis as additional information becomes available. Subscribe to the State Forum listserv and check back often to get the most up to date information, examples and tools.”  

Toolkit v1 – Planning Fundamentals – December 2009 Release
Includes Modules:
Planning Overview
Governance
Finance
Technical Infrastructure
Nationwide Health Information Network
Grants Management  

Toolkit v2 – Additional Modules – Early 2010 Release
Includes Modules:
Business Operations
Technical Operations
Legal/Policy
Privacy and Security
Program Coordination and Leverage
Guidance on Meaningful Use
Module Content and Structure  

“Each module of the Toolkit contains a variety of information designed to foster learning on the topic and support states making design decisions and carrying out implementation approaches. Each Module is structured to include:  

•Overview information about the topic
•Frequently Asked Questions (FAQ’s), updated regularly in response to states’ issues and inquiries
•Resources, including reference materials, tools and other decision supports
•Case Studies and Examples
•Links to Federal Program documents and guidance released by ONC and other agencies”

ONC Posts Roles and Bios for Communications, Adoption, State HIE/Beacon Directors: Deering, Kendall, Cronin
Office of the National Coordinator (ONC) for Health Information Technology posted roles and bios on March 8, 2010,  for
–Acting Director, Office of Communications, Mary Jo Deering, PhD;
–Acting Director, Office of Provider Adoption Support (OPAS), Mat Kendall, MPH; and
–Director, Office of State and Community Programs, Kelly Cronin, MPH, who oversees the State HIE Cooperative Program and Beacon Community Program. Roles and bios are excerpted from ONC Web site:

Mary Jo Deering, Ph.D.
Acting Director, Office of Communications
“Mary Jo Deering, Ph.D, is currently the Acting Director for Communications in the Office of the National Coordinator for Health Information Technology (ONC), U.S. Department of Health and Human Services (HHS).  She leads comprehensive, HHS-wide communication activities related to the Health Information Technology for Economic and Clinical Health (HITECH) Act, which provided $2B to ONC to support the transformation of American health care through the adoption and meaningful use of HIT and the secure, interoperable exchange of health information.  She also oversees ONC’s cooperative agreement with the National eHealth Collaborative, a public-private partnership that promotes the development of a nationwide health information system.

“Previously, Dr. Deering was the Director for Informatics Dissemination and Outreach in the National Cancer Institute’s Center for Biomedical Informatics and Information Technology, which leads the cancer Biomedical Informatics Grid (caBIG).  She also served as Lead Staff for the NCVHS National Health Information Infrastructure Workgroup, and for the NCVHS Workgroups on the Nationwide Health Information Network and on Secondary Uses of Data, all of which provided recommendations for the HHS Secretary. While serving as Deputy Director for eHealth and Management in the HHS Office of Disease Prevention and Health Promotion, she led innovative programs in consumer health informatics, including convening the first scientific panel that laid the foundations for evaluating interactive online consumer health programs and promoting their effectiveness.   Dr. Deering served on the Federal Communication Commission’s Advisory Committee on Telecommunications and Health Care.”

Mat Kendall, MPH
Acting Director, Office of Provider Adoption Support (OPAS)
“Mat is currently the Acting Director of the Office of Provider Adoption Support (OPAS), in the Office of the National Coordinator for Health Information Technology (ONC).   OPAS is responsible for administering the Regional Extension Center (REC) cooperative grant program, which is working with organization across the Country to assist primary care providers in priority settings to achieve meaningful use of an electronic health records system.  OPAS is also responsible for running the Health Information Technology Research Center (HITRC), which will assist RECs across the country to communicate and share best practices, tools and other resources.  Finally, OPAS is responsible for administering the Workforce Community College cooperative agreement programs, which will partner with community colleges to train students for specific fields related to health information technology.  

“Prior to working at ONC, Mat was the Director of Operations for the New York City Department of Health and Mental Hygiene’s Primary Care Information Project (PCIP). The PCIP helped primary care providers in medically underserved communities adopt electronic health record systems.  In addition to being responsible for managing the program’s budgets, contracts and staffing, Mat managed teams responsible for outreach, EHR implementation, hardware support, and other aspects of the implementation process.  During Mat’s time at the PCIP, nearly 1,500 providers were recruited to the program and implemented electronic health record systems.  

“Prior to working for the PCIP, Mat served as Executive Director of the Indian Health Center of Santa Clara Valley, a federally-qualified health center in San Jose California.  He was responsible for writing a successful “330 New Start” grant for the Center and conducted a capital campaign that enabled the IHC to purchase a new building and to overhaul its information technology infrastructure.  Mat has a Masters in Public Health from Johns Hopkins University and a B.A. from Haverford College.”

Kelly Cronin, MPH
Director, Office of State and Community Programs
“Kelly Cronin directs the Office of State and Community Programs in the Office of the National Coordinator for Health Information Technology. She has been involved in establishing and evolving the national agenda for Health IT over the last 6 years in various roles in ONC, the Office of the Secretary, and the Centers for Medicare and Medicaid Services. She currently oversees the State Health Information Exchange Cooperative Agreement Program and Beacon Community Programs in ONC.  

“Prior to ONC, Ms. Cronin directed patient safety initiatives at the Food and Drug Administration and coordinated the drafting of the Patient Safety and Quality Improvement Act while working for the House Energy and Commerce Health Subcommittee. Her work experience also includes health policy analysis, health services research, and clinical trial coordination. She holds a masters degree in Public Health from George Washington University (GWU), and is a lecturer in the Department of Health Policy.”

Going Beyond Paper and Pencil: Investments in Health IT
Posted on The White House Blog by Secretary Kathleen Sebelius,  Secretary of Health and Human Services, on February 12, 2010 at 05:00 PM EST

“Keeping track of huge piles of paperwork is not an easy task for anyone. Imagine doing that for our entire health care system. In effect, that is what is going on with our current paper and pencil system of medical record keeping — until now.
 
“At the Department of Health and Human Services, part of our mission is to ensure quality health care for all Americans. And today I am excited to announce that we are delivering on this in the form of over $750 million in new grants that are part of a federal initiative to build capacity to enable widespread meaningful use of health IT, helping doctors adopt electronic medical records.
 
“As part of the Recovery Act, the legislation President Obama signed into law last year to help strengthen the economy, these grants benefit both patients and doctors by cutting costs, eliminating paperwork, and helping doctors deliver high-quality, coordinated care. They also help eliminate errors that come with having a paper and pencil system and save patients from having to fill out the same form dozens of times.
 
“You can find examples of this from across the country.  At one health system, they used electronic health records to identify older women who hadn’t received an osteoporosis screening and mail them personal letters encouraging them to get screened.  Screenings went up 300%. 
 
“At another health system, only a third of their diabetes patients were receiving the recommended foot and eye exams.  They started tracking these patients using electronic health records, and within five months, the share of patients getting the recommended exams doubled to around two out of three.
 
“Yet despite all these benefits, only 20 percent of doctors and 10 percent of hospitals have even basic electronic health records today.  That’s because even though many doctors around the country can see the potential benefits, there are also obstacles.
 
“That’s where these grants come in. We want to spread the benefits of health information technology to our entire health care system. Led by our National Coordinator for Health IT, Dr. David Blumenthal, our grants team has identified major areas where we can begin to implement new technology to make delivering health care more efficient and more effective. Read Dr. Blumenthal’s blog about it here.
 
“Electronic health records will provide major technological innovation to our current health care system by allowing doctors to work together to make sure patients get the right care at the right time and want to be clear that in all our Health IT investments, patient privacy is our top priority.”

Blumenthal Update Letter #9:
Advancing Health Information Exchange 
emailed from ONC February 12, 2010  

Dr. David Blumenthal

 A Message from Dr. David Blumenthal, National Coordinator for Health Information Technology  

Today we announce the first cooperative agreement awards authorized by the Health Information Technology for Economic and Clinical Health (HITECH) Act.  It marks a major milestone in our journey towards nationwide adoption and meaningful use of health information technology (health IT).   One set of awards provides $386 million to 40 States and qualified State-Designated Entities to rapidly build capacity for exchanging health information across the health care system both within and between states through the State Health Information Exchange Cooperative Agreement Program. The other awards provide $375 million to create 32 Regional Extension Centers (RECs) that will support the efforts of health professionals, starting with priority primary care providers, to become meaningful users of electronic health records (EHRs). Additional awards will be made in both programs over the coming weeks. Together, these programs will help modernize the use of health information, improving the quality and efficiency of care for all Americans. 

As part of the State Health Information Exchange Cooperative Agreement Program, states will play a leadership role in achieving HIE to meet health reform goals. The funds awarded will be used to establish and implement plans for statewide HIE by creating the appropriate governance, policies, and technical services required to support HIE. Developing this state-level capability will help us break down the   current barriers to HIE and help providers to qualify for Medicare and Medicaid incentives under the HITECH Act. The awards will also strongly encourage states to consider participating in the Nationwide Health Information Network as an approach to HIE.  This would create a pathway toward seamless, nationwide health information exchange. 

While the State HIE awards will strengthen capacity for health information exchange, the Health Information Technology Extension Program awards will establish RECs to deliver direct outreach, education, and technical assistance services to health care providers in their regions. Each REC will focus most intensively on the physicians, physician assistants, and nurse practitioners who work as part of individual and small group primary care practices, as well as those who dedicate themselves to providing health care to the underserved. Primary care providers in small practices provide the great majority of such services in the U.S. but have limited resources to implement, meaningfully use, and maintain EHR systems. On-site technical assistance for these priority primary care providers will be a key service offered by the RECs.   RECs will assist providers who have not adopted EHRs, as well as those who have but need help progressing to meaningful use.  Regional extension centers will also help providers keep health information private and secure. 

The Health Information Technology Extension Program and the State Health Information Exchange Cooperative Agreement Program are critical components to the end of a nation-wide interoperable, private and secure electronic health information system.  I look forward to working in collaboration with each state and REC as they establish their programs, begin work within their communities, and promote the transformation of our health care system. I applaud each awarded entity for its dedication to the mission of improving the quality of health care and for the leadership and guidance it will provide. 

Sincerely,
David Blumenthal, M.D., M.P.P.
National Coordinator for Health Information Technology
U.S. Department of Health & Human Services 

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.

Sebelius, Solis Announce Nearly $1 Billion Recovery Act Investment in Advancing Use of Health IT, Training Workers for Health Jobs of the Future

Grant Awards to Help Make Health IT Available to Over 100,000 Health Providers by 2014, Support Tens of Thousands of Jobs Nationwide
Press Release from HHS on February 12, 2010

WASHINGTON, DC – Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis today announced a total of nearly $1 billion in Recovery Act awards to help health care providers advance the adoption and meaningful use of health information technology (IT) and train workers for the health care jobs of the future. The awards will help make health IT available to over 100,000 hospitals and primary care physicians by 2014 and train thousands of people for careers in health care and information technology. This Recovery Act investment will help grow the emerging health IT industry which is expected to support tens of thousands of jobs ranging from nurses and pharmacy techs to IT technicians and trainers.

The over $750 million in HHS grant awards Secretary Sebelius announced today are part of a federal initiative to build capacity to enable widespread meaningful use of health IT. This assistance at the state and regional level will facilitate health care providers’ efforts to adopt and use electronic health records (EHRs) in a meaningful manner that has the potential to improve the quality and efficiency of health care for all Americans. Of the over $750 million investment, $386 million will go to 40 states and qualified State Designated Entities (SDEs) to facilitate health information exchange (HIE) at the state level, while $375 million will go to an initial 32 non-profit organizations to support the development of regional extension centers (RECs) that will aid health professionals as they work to implement and use health information technology – with additional HIE and REC awards to be announced in the near future. RECs are expected to provide outreach and support services to at least 100,000 primary care providers and hospitals within two years.

“Health information technology can make our health care system more efficient and improve the quality of care we all receive,” said Secretary of Health and Human Services Kathleen Sebelius. “These grant awards, the first of their kind, will help develop our electronic infrastructure and give doctors and other health care providers the support they need as they adopt this powerful technology.”

The more than $225 million in DOL grant awards Secretary Solis announced will be used to train 15,000 people in job skills needed to access careers in health care, IT and other high growth fields. Through existing partnerships with local employers, the recipients of these grants have already identified roughly 10,000 job openings for skilled workers that likely will become available in the next two years in areas like nursing, pharmacy technology and information technology. The grants will fund 55 separate training programs in 30 states to help train people for secure, well-paid health jobs and meet the growing employment demand for health workers. Employment services will be available via the Department of Labor’s local One Stop Career Centers, and training will be offered at community colleges and other local education providers.

“The Recovery Act’s investments are making a positive difference in the lives of America’s working families,” said Secretary of Labor Hilda L. Solis. “The investments announced today will ensure thousands of workers across the nation can receive high-quality training and employment services, which will lead to good jobs in healthcare and other industries offering career-track employment and good pay and benefits.”

The HHS and DOL awards are part of an overall $100 billion investment in science, innovation and technology the Administration is making through the Recovery Act to spur domestic job creation in growing industries and lay a long-term foundation for economic growth. In addition to the 10,000 jobs the DOL grantees expect to fill with freshly trained workers, the health IT extension centers are expected to hire over 3,000 technology workers nationwide in the months ahead. Overall, the Administration investments in health IT and training will help significantly expand an emerging industry expected to support tens of thousands of secure, well-paid jobs nationwide.

A complete listing of the state HIE, REC and job training grant recipients is as follows:

State HIE Awards:

Note: Per ONC Web site: “Over the next several weeks the remaining cooperative agreements will be awarded to approved applicants; these awardees will join the 40 awardees announced today in advancing mechanisms for health information sharing in their states and across the country.”

Regional Extension Center Awards:
(For an interactive map on geography covered by REC Awards, click here and go to bottom of page.)

 Job Training Awards:

Additional information about the state HIE and RECs may be found at ONC Site on State HIE Coop Program and http://healthit.hhs.gov/extensionprogram

Information about other health IT programs funded through the American Recovery and Reinvestment Act of 2009 can be found here: http://HealthIT.HHS.gov

Information about Healthcare/High Growth Grants, and other DOL training programs is available at http://www.doleta.gov/.

For more information about the Recovery Act, please visit:
www.hhs.gov/recovery ,
www.dol.gov/recovery and
http://www.recovery.gov/.

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