In finalizing 2009 agenda, ONC also looks ahead

While the Health and Human Services Department must still rule on the definition, standards and certification requirements for meaningful use, the Office of the National Coordinator for Health IT and its advisory team are moving ahead with plans for next year and beyond.

“We are beginning to think about what follows and the implementation of programs under way and some of the thorny issues we will be dealing with in the implementation process,” said Dr. David Blumenthal, the national health IT coordinator.

At a Dec. 15 meeting of ONC’s Health IT Policy Committee, Dr. Paul Tang, the panel co-chairman, said that it will hold hearings in early 2010 so that public and private healthcare providers and other organizations can contribute to the development of 2013 and 2015 meaningful use criteria.

In January, representatives of states will offer their view of barriers and prospects for information exchange in their regions and coordination with federal health IT programs. In February, experts will be invited to discuss sharing data, including outcomes, with patients and their families.

Meanwhile, the healthcare IT community awaits the product of a year’s work by ONC and its advisors: federal meaningful use rules that will govern a good portion of health IT investment and development over the next five years.

The Centers for Medicare and Medicaid Services is expected to publish before the end of the year a regulation defining meaningful use and conditions that healthcare providers must meet to be eligible for incentives under the stimulus. The public will have 60 days in which to comment on it.

Also anticipated this month is ONC’s release of an interim final rule on certification standards and a proposed rule for the certification process. The standards rule will detail the standards for what constitutes a certified EHR.

The ONC has had its hands full: in the past few months, it announced plans to award grants for a total of 70 regional extension centers to support health IT adoption and regional information exchange; state health information exchange programs; 70 community college workforce training and five curriculum development programs; and 15 “beacon” communities intended to inspire and teach others about using electronic health record systems and information exchange.

“We will make more announcements of programs over the next weeks and months,” Blumenthal said, adding that the programs to date relate to one another. “We’d like to think that their relationships will be synergistic and that they will support one another,” he said.

Regional extension centers will assist physicians with health IT adoption at the local level and may be incorporated within beacon communities. Some of the community college programs could also be located in beacon communities or in the same locations as regional extension centers. The goal of the community college programs is to train skilled workers who will staff the beacon communities and regional extension centers, Blumenthal said.

“We hope that all of these will be supported by the infrastructure that states will facilitate to promote exchange and that the nationwide health information network (NHIN) will be one of the resources that states make available,” he said.

ONC is also internally bracing for the future. The office is “changing dramatically even as we are trying to implement these programs,” Blumenthal said at the committee meeting. As an example,ONC announced earlier this month that it would reorganize some of its operations and add new senior positions, such as chief privacy officer. It will also double in size to 100 staffers over time.