HIMSS News
Healthcare Reform Update: President signs the American Recovery and Reinvestment Act of 2009
February 20, 2009 - The health IT policy environment received an incredible jolt this week. On Tuesday, February 17, President Barack Obama signed the American Recovery and Reinvestment Act of 2009 (ARRA) into law, and greatly magnified the federal government’s role in broadening health IT’s impact on healthcare delivery in the U.S. The legislation provides economic stimulus at $787 billion, including over $19 billion for health IT. Details and many resources – including an analysis, summary, and FAQs – can be found on the HIMSS website.
The ARRA codifies the Office of the National Coordinator for Health Information Technology (ONC), and makes the National Coordinator responsible for distributing and managing funds and resources, including competitive planning and implementation grants to states for state-level initiatives or state-sponsored health information exchanges; grants and loans to providers (with quality reporting, standards, and certification requirements), and a Health IT Extension Program, with a national center and regional centers that provide outreach to help providers adopt health IT using "good technologies and good implementation strategies."
In the truest sense of the term coordinate, National Coordinator Robert Kolodner, MD, apparently is reaching out to federal agency colleagues to leverage their collective expertise to develop the government’s plan. As you might imagine, the regulatory changes required as a result of ARRA will be enormous. For that reason, during HIMSS’ meetings with numerous federal agencies this week, we heard that federal agencies have been planning for weeks on how to operationalize the stimulus package programs. For instance, we learned that HHS held an agency-leader level meeting earlier this week to further refine agency-based plans. The agency-wide approach is said to be dividing the funds and programs into three areas: Prevention and Wellness, Health IT, and Comparative Effectiveness. Agency-specific funds will have an execution plan developed from within the agency, while cross-agency funds will be pooled with multiple agencies developing the execution plans.
In addition to funding, the legislation requires ONC to work with NIST to develop a plan to move forward with two federal advisory committees (FACA) to address standards and policy development for the Nationwide Health Information Network. With respect to the Standards Committee, ONC and NIST have a longstanding relationship, and relationships with both HITSP and CCHIT. Given the December, 2009 deadline for establishing interim standards for adoption and interoperability, HIMSS fully expects HITSP and CCHIT to play important roles in future standards harmonization and certification programs.
As for the HIT Policy Committee and the HIT Standards Committee in the ARRA, the FACA requirement is a legislative response to the sun-setting of the American Health Information Community and the new emergence of the National eHealth Collaborative (NeHC) as a non-profit organization. The ARRA allows the NeHC to modify its charter to meet the FACA requirement, thereby giving the Secretary the option of considering NeHC as the Policy Committee. The Policy Committee, along with the Standards Committee and related certification activity, are critical to the continued development of secure healthcare data exchange, and HIMSS supports a forward-looking solution to the future of NeHC, HITSP, and CCHIT.
With respect to comparative effectiveness as the third area of HHS focus, AHRQ has $1.1 billion and will be collaborating with the HHS and the National Institutes of Health to ensure efficient use of the funds. The coordinated comparative effectiveness activities will look at clinical and business process trends and opportunities to drive up quality outcomes and cost effectiveness of care.
In addition to all the requirements for expanding adoption and meaningful use of EHRs, ONC and HRSA will be working on grants for medical curricula development to ensure providers receive necessary and appropriate training on using health IT. ONC is also required to provide grants to ensure healthcare professionals have appropriate informatics training. HIMSS and many others in the industry are committed to creating a reality in which there will be enough qualified workers to address this massive build-out.
Finally, the regulatory changes require industry input and comment. HIMSS has a strong process of actively engaging our members in public comment opportunities, thereby ensuring the voice of the practitioner is heard, and embedded into, resulting regulations. We encourage all members to be prepared to lend your voices and expertise to the development and review of the impending regulations.
Our members can also learn more details about the legislation through an upcoming webinar series. HIMSS will convene the second in a five-part educational webinar series on Monday, February 23, at 12 pm EST. The series is complimentary for HIMSS members. HIMSS Sr. Director for Privacy and Security Lisa Gallagher will provide an overview of the changing privacy and security requirements that are in the ARRA.
We welcome any questions you may have. For additional information concerning health IT policy and HIMSS government relations activities, please access our Web site, or contact us via email.
