Broadband and BeyondDialed-In to Health IT

TIA is closely tracking the Broadband Stimulus and other provisions of the American Recovery and Reinvestment Act that directly impact the the information and communications technology (ICT) industry. (See "Roadmap to Recovery" at tiaonline.org to track Broadband Stimulus.) Some of the most innovative provisions in ARRA are those addressing Health IT (HIT), which accounts for nearly $20 billion in stimulus funds.

In this issue of TIA's ICT2020, we take an in-depth look at the federal government's plans for Health IT stimulus as TIA serves it dual mission of educating and informing both policy makers about the benefits of Health IT and TIA members about the government's process for allocating the funds and the impact on ICT industry.

Stimulus funds totaling $2 billion have been allocated to the Office of the National Coordinator (ONC) for Health Information Technology at the Department of Health and Human Services (HHS). These funds will be used to develop a nationwide health information technology infrastructure. The program will enable the electronic use and exchange of information to ensure that the full benefits of Health IT can reach underserved Americans in remote locations as soon as possible.

Additionally, $17 billion in incentives will begin flowing in 2011 through the Medicare and Medicaid programs to physicians and other health care providers who "meaningfully use" use electronic health records (EHRs).


Defining 'Meaningful Use'

The guidelines for standards and policy being developed by ONC are directly related to how providers will receive funding when adopting an EHR system. Of particular importance is the definition of "meaningful use," which establishes requirements for providers regarding how EHRs are maintained and transmitted and how they benefit patients.

TIA sent recommendations on behalf of the ICT industry to Dr. David Blumenthal, National Coordinator for Health IT, for its Health IT Policy Committee proposal for a Meaningful Use Matrix, which establishes conditions that must be satisfied over time for a health care provider to receive funds for the "meaningful use" of EHRs. TIA has also been working with the IT industry representative on the Committee, Judith Faulkner, CEO and Founder of Epic Systems Corp., and has sent policy recommendations to her as well.

TIA advocated for:

  • "Meaningful use" of EHRs to include transportability via secure wireline and wireless networks to medical providers;
  • Delivery of EHRs through technology-neutral standards that allow providers to implement flexible, standards-based EHR systems based on their own choice of hardware, software and network technologies;
  • Allowing access to EHRs by patients anywhere on their own choice of consumer electronics (e.g., PCs, smartphones); and
  • Integration into the technologies and systems for diagnosis and delivering patient care.

TIA also recommended that: 1) ONC funding for EHR adoption should begin as quickly as possible; 2) certification criteria should allow for the current and continuing deployment of Health IT; 3) a systems-based approach will ensure data interoperability and end-to-end transport of accurate, protected health data; and 4) maximization of existing standards and technologies will help ONC to avoid difficult and costly delays.

Stimulus Funds Available Through the ONC for Health Information Technology

Types of available grant money, totalling $2 billion:

  • $300 million for health information exchange initiatives
  • $20 million to support the National Institute for Standards and Technology's development of data standards
  • $5 million for administration purposes
  • $1.7 billion for:
    • Establishment of a Health IT Research Center
    • Technical assistance and development of best practices to accelerate efforts to implement and utilize HIT that allows for electronic exchange and use of information
    • Assistance for the creation of HIT Regional Extension Centers
    • State Grants to facilitate and expand electronic movement and use of health information among organizations
    • Loan programs to providers to facilitate the widespread adoption of certified EHRs
    • Demonstration programs to integrate certified HIT into clinical education
    • Assistance to institutions to establish or expand medical health informatics education programs for health care and information technology

Additionally, a notification for funding availability for the regional extension center grants will be published by the end of FY 2009.

Stimulus Funds Available Through the Centers for Medicare and Medicaid Services (CMS)

$17 billion in incentives for physicians and other health care providers to adopt and use EHRs will become available in FY 2011 and end in FY 2016.

TIA on Health IT Policy and Standards

TIA's recommendations are based on the dedicated work of its government affairs Health IT Working Group (HITWG), which has the following mission:

The Health IT Working Group (HITWG) will focus on the Administration's and Congress' development of Health IT policies, particularly at the Department of Health and Human Services, its HIT Policy and Standards Committees, and the FCC. It may offer these organizations comments, best practices, and perspectives of its member companies from industry experience in designing and deploying networks that transport and store protected health information. It will monitor and report on key Health IT policies and proposals of the government and interested private parties. Additionally, the HITWG will advocate for federal funding for deployment of health information technology in rural and underserved areas. To better enable mobile and wireless applications for Health IT, the HITWG will also advocate for effective spectrum use for Health IT. The HITWG will advocate for the adoption of fixed and mobile computing devices and technologies that improve health care communications and enhance patient care. The HITWG will advocate in a manner consistent with established TIA policies and that promotes Health IT infrastructure development according to open, industry-led standards processes.

As part of its standards development program, TIA's Health ICT Engineering Committee (TR-49) is responsible for development and maintenance of standards for the healthcare ICT applications that involve medical devices, network infrastructure, applications and operations support.

The HITWG and TR-49 both comprise representatives from the ICT industry whose participation is voluntary and uncompensated.