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HRSA and Health Information Technology


HRSA s Office of Health Information Technology ORHP All Programs Meeting August 28, 2007 Cheryl Austein Casnoff, MPH Associate Administrator US Department of Health ... – PowerPoint PPT presentation

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Title: HRSA and Health Information Technology

HRSAs Office of Health Information
TechnologyORHP All Programs MeetingAugust 28,
Cheryl Austein Casnoff, MPH Associate
Administrator US Department of Health and Human
Services Health Resources and Services
Administration Office of Health Information
  • About the Office of Health Information Technology
  • HIT What is Happening at the Federal State
  • Advancing HIT through Networks
  • Using Telehealth to Improve Access and Quality
  • OHIT Activities
  • Additional Resources

Health Resources and Services Administration
  • Programs reach into every corner of America,
    providing a safety net of direct health care
    services to 20 million people each year (about 1
    in every 15 Americans).
  • HRSA has made significant progress in meeting the
    needs of the uninsured and underserved
    individuals, special needs populations, and many
    others through its efforts to
  • Improve health care
  • Improve health outcomes
  • Improve quality of care
  • Eliminate health disparities
  • Improve public health and health care systems
  • Improve ability of the health care system to
    respond to public health emergencies

HIT Goals for the Safety Net Providers
  • Bring HIT to Americas safety net providers which
  • Improve quality of care
  • Reduce health disparities
  • Increase efficiency in care delivery systems
  • Increase patient safety
  • Decrease medical errors
  • Prevent a digital divide

Office of Health Information Technology
  • Formed in December 2005, as the principal advisor
    to the HRSA Administrator in developing an agency
    wide HIT strategy.
  • Mission
  • The Office of Health Information Technology
    (OHIT) promotes the adoption and effective use of
    health information technology (HIT) in the safety
    net community.

HRSA HIT Quality Strategy
  • In May 2006, HRSA reconfirmed its goal to improve
    the quality of health service and outcomes for
    all patients served by HRSA grantees

HRSA HIT Quality Strategy
  • HRSA's goal is not simply to collect data it is
    also important that the data be used to track
    individual and population health outcomes and
    improve patient care. The long-term vision of
    HRSA and OHIT is to transform systems of care for
    safety-net populations through the effective use
    of HIT.

Data Reporting
Quality Measures
Performance Measures
Office of Health Information Technology - Goals
  • Develop a strategy and supportive policy that
    leverages the power of health information
    technology and telehealth to meet the needs of
    people who are uninsured, underserved and/or have
    special needs.
  • Identify, disseminate and provide technical
    assistance to health centers and other HRSA
    grantees in adopting model practices and
  • Disseminate appropriate information technology
    advances, such as electronic medical records
    systems or provider networks.
  • Promote grantee health information technology
    advances and innovations as models.
  • Work collaboratively with foundations, national
    organizations, the private sector, and other
    Government agencies to help HRSA grantees adopt
    health information technology.
  • Ensure that HRSA health information technology
    policy and programs are coordinated with those of
    other U.S. Department of Health and Human
    Services components.

HHS HIT Funding
  • FY 2008 Federal budget proposes 165 million for
    HIT in the Department of Health and Human
  • 118 million ONC
  • 45 million AHRQ
  • 2 million ASPE
  • Agencies funding and implementing HIT
  • HRSA
  • CMS
  • NIH
  • AHRQ
  • FDA
  • IHS
  • CDC

Office of the National Coordinator for Health
Information Technology
  • The ONC advises the Secretary of HHS on health IT
    policies and initiatives, and coordinates the
    Departments efforts to meet the Presidents goal
    of making an electronic medical record available
    for most Americans by 2014.
  • Initiatives include
  • American Health Information Community (AHIC)
  • Product Certification
  • Standards
  • Nationwide Health Information Network
  • Activities with the National Governors
    Association Center for Best Practices

Centers for Medicare Medicaid Services
  • Section 1115 Waiver (DRA)
  • States may apply for waiver to increase their
    flexibility to develop Medicaid plans that may
    extend coverage to additional populations,
    increase covered services and control costs
  • Deficit Reduction Act of 2005 (DRA)
  • Grants states flexibility to design different
    coverage options for different populations
    without applying for a Section 1115 Waiver
  • Opportunity to incorporate HIT initiatives into
    state Medicaid reform plans
  • Medicaid Transformation Grants
  • DRA authorizes new grant funds to States for the
    adoption of innovative methods to improve
    effectiveness and efficiency in providing medical
    assistance under Medicaid.
  • 103 million in awards announced on January 25,

Source 2006 Medicaid Congress Conference Summary
State Support for HIT
  • Over 240 health information technology bills
    were introduced in 2007 at the State level. 
  • A total of 45 bills passed in 28 states and the
    District of Columbia with funding for HIT

State HIT Topics
  • Electronic Medical Records
  • June 27, 2007 - Louisiana has allocated 30
    million to Phase 1 of their statewide electronic
    medical records system for state public hospitals
    and medical centers
  • Health Data Exchange
  • 4/24/07 Maryland will devote 30 million over
    the next 3 years to establish a regional data
  • Grant Opportunities
  • 3/27/07 Idaho will offer 2.5 million in in
    competitive grants to Community Health Centers
    for equipment, including HIT equipment
  • School HIT
  • 1/16/07 District of Columbia will use 200,000
    HIT in public and charter school nurse suites

HRSA Health Center Controlled Networks (HCCN)
  • Led by HRSA-funded health centers.
  • Supports the creation, development, and operation
    of networks of safety net providers to ensure
    access to health care for the medically
    underserved populations through the enhancement
    of health center operations, including health
    information technology.

Advancing HIT through Networks
  • Why Networks?
  • Collaboration of health centers and other safety
    net providers.
  • Economies of scale/cost efficiencies/volume.
  • Enhanced efficiencies in business and clinical
    core areas.
  • Higher performance and value.
  • Sharing of expertise and staff among

HRSA FY 2007 Network Grant Opportunities
  • Planning Grants
  • Small amounts (less than 100,000 per year) to
    plan and start implementing HIT initiatives such
    as EHRs and e-prescribing.
  • Electronic Health Record Implementation Grants
  • 3-year grants to purchase and implement EHRs.
  • HIT Innovation Grants
  • 3-year grants to purchase and implement other
  • High Impact EHRs Implementation Grants
  • 1 year grant for high impact implementation of an
    EHR implementation of new EHRs must be in at
    least 15 sites.
  • Total funding Approximately 20 million

HRSA Telehealth Grant Awards
  • First awards made by ORHP in 1989.
  • HRSA created Office for the Advancement of
    Telehealth as a focal point for Telehealth
    activities in 1998.
  • Awarded over 250 million in grants since 1989.
  • Competitive and Congressionally-mandated projects.

FY 2006 Telehealth Grants
  • Telehealth Resource Center Grant Program
  • 6 awards
  • Telehealth Network Grant Program (including home
  • 16 awards
  • Licensure Portability Grant Program
  • 2 awards
  • Funding of approximately 6.8 million in FY 2007

OHIT Grant Applicants
  • Over 721 Health Centers Applied
  • Representing all Regions of the US and over 25
  • 14 Primary Care Associations
  • 52 Networks
  • 26 Community Health Centers

Telehealth Network Grants
  • To demonstrate how telehealth technologies can be
    used through telehealth networks to
  • Expand access, coordinate, and improve quality of
    health services.
  • Improve and expand the training of health care
  • Expand and improve the quality of health
    information available to health care providers,
    and to patients and their families.
  • Eligibility Open to urban and rural networks,
    but limited funding resulted in only rural
    networks funded.

Telehealth Grants Allow Grantees to
  • Purchase/lease equipment (up to 40 of grant).
  • Pay for organizational development and
  • Conduct internal evaluations on
    cost-effectiveness of services.
  • Provide clinical services, develop distance
    education programs, mentor/precept at a distance.
  • Promote collaboration in the region to improve
    the quality of and access to health services.

Telehealth Network Grants
  • University of Arkansas for Medical Sciences, AR
  • Northern Sierra Rural Health Network, CA
  • Ware County Board of Health, GA
  • The Queen's Medical Center, HI
  • Public Hospital Cooperative SE Idaho Inc, ID
  • Illinois Department of Human Services, IL
  • University of Kansas Medical Center Research
    Institute, KS
  • Eastern Maine Healthcare Systems, ME
  • Tri-County Hospital, MN
  • Citizen's Memorial Hospital District, MO
  • St. Patrick Hospital Health Foundation, MT
  • Duke University, NC
  • Children's Hospital Medical Center of Akron, OH
  • Home Nursing Agency Visiting Nurse Association,
  • University of Washington, WA
  • Marshfield Clinic Research Foundation, WI

Telehealth Resource Centers
  • Purpose To promote the cost-effective use of
    Telehealth technologies through technical
    assistance to grantees, potential grantees,
    health care providers, and communities
  • Technical Assistance
  • Dissemination
  • Website
  • Conferences
  • Webinars
  • Peer-to Peer TA
  • Individual TA

FY 2006 Telehealth Resource Center
Grantees/States Covered
  • California Telemedicine and eHealth Center CA
  • Northeast Telehealth Resource Center (Medical
    Center at Lubec) ME, VT, NH, MA
  • Midwest Alliance for Telehealth and Technologies
    Resources (Marquette Hospital) MI, KS
  • Northwest Regional Telehealth Resource Center
    (St. Vincent Foundation) AK, HA, ID, MT, OR, UT,
    WA, WY
  • Great Plains Telehealth Resource and Assistance
    Center (Avera Rural Health Institute) ND, SD,
    NE, MN
  • Center for Telehealth and E-Health Law National

Telehealth Resource Centers Contact Information
  • Center for Telehealth and e-Health Law
  • Phone (202) 230-5090 Web
  • California Telemedicine and eHealth Center
  • Phone (916) 552-7679 Web
  • Great Plains Telehealth Resource and Assistance
  • Phone (888) 239-7092 Web
  • Midwest Alliance for Telehealth and Technology
  • Phone (866) 603-4733 Web
  • Northeast Telehealth Resource Center
  • Phone (207) 287-4060 Web

Licensure Portability GrantsNational Council of
State Boards of Nursing Grant
  • Aassist states in adoption of the Nurse Licensure
    Compact (NLC).
  • Mutual recognition licensure model based on the
    U.S. Drivers License Compact.
  • Allows both RN and LP/VN nurses to hold one
    license to practice in their home state while
    being permitted to practice in other
    participating NLC states, both physically and
  • Develop strategies to overcome barriers to
  • Assess the costs and benefits of such strategies.
  • Nurse Summit to increase knowledge about the NLC
    among states.
  • Assist states in defraying costs of criminal
    background check (CBC) for licensees a major
    barrier to adoption in some states.
  • Development of standardized financial impact
    tools to evaluate the cost of implementing the
    NLC and CBCs.

Licensure Portability GrantsFederation of State
Medical Boards of the United States, Inc.
  • To create demonstrations of models that reduce
    licensure barriers to telehealth for physicians
    practicing across state lines.
  • Implements 2 proposals developed by medical
    boards in the northeastern (ME, MA, VT, CT, RI
    and NH) and western regions (ND, KS, CO, MN, IA,
    ID, OR, and WY) to share licensure information
    across jurisdictions.
  • Development of a centralized data management
    system with immediate access to credentials that
    confirm physicians qualifications to practice
    reducing the burden faced by applicants seeking
    verification of their credentials in multiple
  • Expected Outcomes
  • Reduce amount of time and paperwork required to
    issue licenses, thereby encouraging more
    physicians to participate in electronic practice
    across state lines.
  • Facilitate mobilization of physicians in
    disasters when the need for immediate and
    accurate physician information is essential.

A Strategy for Providing HIT Technical
Assistance (TA)
TA Tools developed by OHIT form a mechanism to
increase health IT knowledge in the grantee
community. September 2007
TA HRSA Portal
  • In partnership with the Agency for Health Care
    Research and Quality (AHRQ) HRSA has established
    a Health IT Community for HRSA grantees.
  • Serves as a virtual community for health centers,
    networks and PCAs to collaborate around the
    adoption of technologies promoting patient safety
    and higher quality of care.
  • Facilitates collaboration via discussion forums
    where health centers facing similar challenges
    can share thoughts and lessons from experiences
    with a variety of IT systems and scenarios.

TA HRSA Portal
  • Will include tabs for maternal and child health,
    rural health, HIV/AIDS grantees, and telehealth
  • Creates a central hub for communication across
    geographically disparate sites, allows team
    members to view important announcements,
    documents, tasks, events, and discussions related
    to their initiative.
  • Private community capability
  • A virtual place for grantees to have a place for
    project plan tasks lists, upload documents,
    create calendars, and have discussion boards on
    the project.
  • Grantee controls who has access to the community.
  • Perfect for large health centers, networks, and
    people working with other partners.

TA HRSA Portal
  • Includes a repository of information on IT
    targeted to the health center population members.
  • For login name and password for the HRSA Health
    IT Community, email to obtain
    logins for you and your staff.
  • The HRSA Health IT Community news is updated
    daily with articles and news releases related to
    HIT.  Be sure to check it!

(No Transcript)
TA - HIT Toolbox
  • An interactive Toolbox that will assist health
    centers, maternal and child health, rural health,
    and HIV/AIDS grantees in HIT planning,
    implementation, and sustainability.
  • Dissemination of the HIT Toolkit is for November
  • Focus
  • Collaborative solutions
  • Module based
  • Interactive
  • Questions and answers
  • We will be sharing the draft toolkit for feedback
    among a small set of stakeholders in
    September/October.  If you would like to be part
    of this group, please email
    letting us know.

TA - HIT Toolbox
  • The toolbox is organized by 9 topic-specific
  • Introduction to Health IT     
  • Getting Started       
  • Opportunities for Collaboration        
  • Project Management and Oversight 
  • Planning for Technology Implementation      
  • Organizational Change Management and Training
  • System Implementation       
  • Evaluating, Optimizing, and Sustaining          
  • Advanced Topics   

TA - HIT TA Center
  • Provide consistent HIT TA to HRSA grantees.
  • TA One to Many" Calls
  • HIT 101
  • Workflow Analysis and HIT
  • Slides, transcripts and recordings of calls are
    on the HRSA Health IT Community.
  • Peer-to-peer technical assistance to obtain TA
    from an experienced peer in HIT.
  • Consultant technical assistance to obtain TA from
    an experienced consultant in HIT.

OHIT Strategic Plan
  • A strategic plan that will define
  • OHITs role in promoting HIT adoption across HRSA
  • OHITs relationships with HRSA offices and
  • OHITs relationships with its grantees and other
  • How OHIT addresses its mission to promote the
    adoption and effective use of HIT in the safety
    net community
  • Expected release November 2007

HRSA HIT Grantee Meetings
  • Promote collaboration, knowledge sharing, and the
    leveraging of resources among HRSA grantees to
    promote HIT adoption by safety net providers.
  • Audience approximately 500 HRSA grantees
  • Meeting Date November 5 7, 2007
  • Location Crystal City, VA
  • Website http//

Areas to Watch
  • Personal health records
  • Continuous records of one's diagnoses,
    medications, treatments and outcomes--portable
    and interoperable with electronic health records,
    clinical decision support and clinical data
    repositories--will dramatically improve
    continuity of care by 2014.
  • Access to health IT for disadvantaged,
    underserved and vulnerable patient populations
  • IT will help reduce disparities in healthcare
    distribution so that underserved populations are
    not left out.
  • Role of the states
  • States will become much more involved in health
    information exchange initiatives and RHIOs,
    setting policies and monitoring service delivery
    to improve accessibility to evidence-based

Areas to Watch
  • Biosurveillance and Public Health
  • Public and private healthcare providers will make
    extensive use of biosurveillance when responding
    to natural disasters, epidemics and terrorist
    attacks, including identification and management
    of the psychological response to trauma.
  • Continuity of care for military personnel
  • Portable electronic health records will improve
    access to physical and mental health diagnostic
    and treatment services for veterans with physical
    injuries, as well as post-traumatic stress
    disorder and traumatic brain injury.
  • To improve continuity of care, these records
    should include health information from all
    sources, from pre-deployment baselines to
    military hospitals to nursing homes and private
    health care.

  • Remember, this isnt about technology, its
    about transforming the health of the nation. My
    role is to get IT out there to improve the
    quality and efficiency of health care and the
    ability of consumers to manage their own
  • - Robert Kolodner,
  • National Coordinator for Health IT

From iHealth Beat article, Government Tapping
IT To Boost Care, National Health IT Leader
Says. Issue May 18, 2007.
Contact Information
  • Cheryl Austein Casnoff, MPH
  • Associate Administrator
  • 5600 Fishers Lane, 7C-22
  • Rockville, MD 20857
  • Phone 301-443-0210
  • Fax 301-443-1330
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