Friday, August 21, 2009

Funding for HIEs and RHITECs arrives

Yesterday was a landmark day - the HIT Standards Committee approved the quality, clinical care, and privacy/security standards that serve as certification criteria and support meaningful use. At the same time, HHS released $564 million for Healthcare Information Exchange to be given to States/State Designated Entities to accelerate interoperability implementation and $598 million for Regional Healthcare IT Extension Centers (RHITECs) which are applied for competitively (not distributed via state government) to accelerate EHR adoption.

Of interest, the range of award for HIE is $4,000,000 to $40,000,000. Fifty awards will be given.

The range of award for RHITECs is $1,000,000 to $30,000,000 with an average of 8,543,000
Award Floor $ 1,000,000. Seventy awards will be given.

The press release is below.

CHICAGO, IL – Vice President Joe Biden today announced the availability of grants worth nearly $1.2 billion to help hospitals and health care providers implement and use electronic health records. The grants will be funded by the American Recovery and Reinvestment Act of 2009 (ARRA) and will help health care providers qualify for new incentives that will be made available in 2010 to doctors and hospitals that meaningfully use electronic health records.

“With electronic health records, we are making health care safer; we’re making it more efficient; we’re making you healthier; and we’re saving money along the way, ”said Vice President Biden. “These are four necessities we need for healthcare in the 21st-century.”

“Expanding the use of electronic health records is fundamental to reforming our health care system,” said HHS Secretary Sebelius. “Electronic health records can help reduce medical errors, make health care more efficient and improve the quality of medical care for all Americans. These grants will help ensure more doctors and hospitals have the tools they need to use this critical technology.”

The grants made available today include:

Grants totaling $598 million to establish approximately 70 Health Information Technology Regional Extension Centers, which will provide hospitals and clinicians with hands-on technical assistance in the selection, acquisition, implementation, and meaningful use of certified electronic health record systems.

Grants totaling $564 million to States and Qualified State Designated Entities (SDEs) to support the development of mechanisms for information sharing within an emerging nationwide system of networks.

The Extension Center grants will be awarded on a rolling basis, with the first awards being issued in fiscal year 2010. Grants to States will be made in fiscal year 2010. Those interested in applying for these grants may visit for more information.

“With these programs, we begin the process of creating a national, private and secure electronic health information system. The grants are designed to help doctors and hospitals acquire electronic health records and use them in meaningful ways to improve the health of patients and reduce waste and inefficiency,” said Dr. David Blumenthal, National Coordinator for Health Information Technology. “They will also help states lead the way in creating the infrastructure for health information exchange, which enables information to follow patients within and across communities, wherever the information is needed to help doctors and patients make the best decisions about medical care.”

The Department of Health and Human Services will also provide additional assistance to health care providers through the Health Information Technology Research Center (HITRC). The HITRC will gather relevant information on effective practices from a wide variety of sources across the country and help the Regional Extension Centers collaborate with one another and with relevant stakeholders to identify and share best practices in EHR adoption, effective use, and provider support.


Bernz said...

Let's say, um, hypothetically, that I'm a guy who has large amounts of experience building large-scale software to exchange information securely (in this case Electronic Evidence and Legal documents). Let's say I, fairly recently, built and sold a successful company doing the above things using SaaS technologies. It was often praised for its scalability and security and ability to easily take disparate data-sources and merge them.

Then let's say I got bored, left this company after a good long tenure there and decided to tackle another industry with a similar problem. Let's say I don't necessarily care if it's a for-profit or not-for-profit endeavor... I just think it's an interesting problem.

If I wanted to be involved in being deeply involved in building an HIE and think I can bring alot to the table, but don't necessarily want to work for the large HIT vendors that I think are building overly complex ways of attacking this problem, where would this hypothetical individual start? Apply for a grant? An organization (here in Boston) that is tackling this problem? Who are some of the players in this space if well-meaning hackers really want to get involved and lend brain/coding/infrastructure power. I'm thinking of just starting my own non-profit HIE-building company, but I don't want to clash if there's already people doing it.

Alex Alexander said...

I have been trying to understand the RFP. It is a very unusual one and extremely complicated. What is the business model?

I have a couple of questions/observations. Well as a start!

1. Does the ARRA specifically say that the Regional Extension Centers have to be not-for-profit or the eligibility to apply is only for not-for-profit? Will this not preclude for-profit companies that have done lot of work helping physicians and health organizations migrate to EHR? Is not the idea here to get the best talent? Price can be negotiated always.

2. The matching sliding funding structure is also interesting. The sliding scale calls for 90% self funding in the third year, possibly as fees from physicians? The fifth year the REC must be self sufficient .What if by 5 years the REC has lived up to its commitment and possibly no further work in the area? Re-structure the company with new revenue streams?

3. We gather that the RFP for the National HITRC is yet to be released? Is this correct? If so will that be a contract or grant?

Would this have been better served as a 5 year contract with option years?

Raises more doubts and questions, the more you read it. Still trying to catch my tail.

Mark Schlack said...

Can you clarify the situation with respect to certification for HITECH? CCHIT has a 2008 standard and will have a 2001 standard, as I understand it. How will the standards you are working on become part of the software certification process for providers that have ongoing EHR projects?

Anonymous said...

Very interesting discussion. I truly think that the points discussed out here regd. the REC's are going to be point of contention looking ahead, towards a successful EMR deployment.
On the issue of REC's competing against each other, I feel this will result in a healthy competition, if they don't get biased for a particular EHR vendor. I believe these REC's should set their own unique business model, as discussed above within the guidelines set-forth in the HITECH act.
This would result in each REC having a set of vendors with similar offering , yet maintaining their own unique selling point.
Each EHR vendor should have their own interpretation of HITECH act, using which the REC's can quote or compete for the jobs.

Regarding the grants given, I believe the staggered form of funding does solve most of the confusion.

Some of the other useful resources on this topic:
REC's putting EHR's to meaningful use
Certification criteria for EHR