Thursday, February 21, 2008

HRSA Comments on HIT

HRSA in the September 2007 Federal Register had asked for comments on what strategies should be used to support HIT among safety net providers. Comments were requested on improving quality, collaborating, general network-related issues, HCCNs sustainability, and building HIT capacity. HRSA received 53 comments from a broad range of stakeholders, including state health departments, non-profit organizations, healthcare providers, and from the health information technology industry.

Some of HRSA’s responses to the many comments appeared in the January 25, 2008 Federal Register such as:

  • HRSA is using the HCCN model for HIT adoption because of the HCCN business model in terms of cost efficiencies, the ability to attract competent staff, and the ability to strengthen health center operations in the marketplace

  • OHIT will continue to foster collaboration among the telehealth network grantees and HCCN grantees. OHIT has interest in HCCNs with at three organizations, large multi-site health centers, and both urban and rural networks

  • HRSA is addressing effectiveness, efficiency, and safety to measure the impact of HIT on quality and views HIT as a tool to use to improve the quality of care. While registries can provide quality improvement, two factors such medication error prevention and live clinical decision support may not improve quality with the use of registries. OHIT and the Center for Quality are working together on efforts for the adoption of HIT and for quality improvement

  • HRSA is working internally across bureaus, programs, offices, and externally with other agencies, existing grantees, associations, networks, and other partners to develop new reporting requirements for clinical outcomes and other program data

  • Over the coming year, OHIT will collaborate with BPHC to provide TA to health centers through OHIT’s Telehealth Resource Centers and BPHC’s State and National Technical Assistance Cooperative Agreements. The collaborations will address the challenges and opportunities for health centers to use telehealth services in underserved urban as well as rural communities. Also, HRSA has developed an internal HRSA HIT Policy Council to enhance communication and collaboration across all of its offices and bureaus

  • Telehealth is a critical component in HRSA’s HIT strategy. OAT initially focused on rural communities but now a greater emphasis is placed on both urban and rural applications for telehealth technologies

  • Some of OHIT’s activities include developing a Telehealth Technical Assistance toolbox available over the web to assist health centers in deploying telehealth services to their communities, and awarding 3 three year OAT grants to support telehealth based home services

  • The telehealth networks are working to integrate EHRs into their services but this is difficult because of the lack of interoperability among the various health information systems

  • HRSA has created a special portal for health centers as part of the AHRQ HIT Resource Center to share information on best practices, literature, and funding opportunities HRSA is including HIE within funding opportunity announcements to promote innovative practices. HRSA realizes that no one source of funding will be sufficient to pay for EHRs and other HIT initiatives. Sustainability after Federal funding will be expected, and grantees will need to move to self-sufficiency within the project period