Health IT Law Blog : Health IT Law Blog : Post & Schell: Law Firm : HIT & Electronic Health Records

HHS Secretary Kathleen Sebelius announced almost $28 million in grants for more than twenty health centers to implement or improve their electronic health records technology.  This funding is allotted from the $2 billion set aside for Health Resources and Services Administration (HRSA) health centers in the ARRA.  HRSA health centers provide medical services for the uninsured and low-income individuals.

According to the HHS press release:

Eighteen grants totaling more than $22.6 million will support EHR implementation. Grants totaling more than $2.6 million will help four grantees implement a variety of HIT innovations, including the creation of health information exchanges among different providers and the incorporation of HIT at dental delivery sites. Another five grants totaling over $2.5 million will help health centers devise plans to use existing EHRs to improve patient health outcomes.

HRSA received $2 billion through the Recovery Act to expand health care services to low-income and uninsured individuals through its health center program. To date, more than $1.3 billion of these funds have been awarded to community-based organizations across the country. HRSA-supported health centers treated 17 million patients in 2008, 40 percent of whom have no health insurance.

You can find the full list of recipients here.

"Secretary Sebelius Releases $27.8 Million in Recovery Act Funds to Expand the Use of Health Information Technology," HHS Press Release (September 29, 2009).

"HHS releases $28M in ARRA funding to accelerate health IT," Healthcare IT News (September 30, 2009).

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The last few weeks saw a tremendous amount of activity in the health IT market.  Dell and Xerox were among the companies trying to capitalize on opportunities created by the ARRA incentives and certain market trends, including high demand for HIT products due to the ongoing digitization of the industry and, more generally, the expanding healthcare needs of an aging population in the United States.

Dell is quickly establishing itself as a major player in health IT.  In April 2009, Dell aligned itself with Wal-Mart and eClinical Works to supply hardware for Wal-Mart's new EHR system.  Last month, Dell rolled out its own EHR system aimed at physicians affiliated with hospital practices, with Tufts Medical Center and Memorial Hermann Health Care System among the early adopters. 

Even more significantly, on September 21, 2009, Dell announced its plans to acquire the health IT vendor Perot Systems Corp. for $3.9 billion.  Perot is a major player in the healthcare industry:  about half of Perot's $2.8 billion in annual revenue comes from the healthcare market; and as much as half of the hospitals that outsource their IT are Perot clients.   Perot runs over 3,000 healthcare applications for its clients, though the company does not have a preferred provider arrangement with a specific application vendor.

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On September 15, 2009, the HIT Standards Committee endorsed a set of privacy and security standards for electronic health record systems. 
These standards will be recommended to Dr. David Blumenthal, the National Coordinator for Health Information Technology, as a basis for establishing the privacy and security criteria for, inter alia, "certified EHR technology" as defined under the HITECH Act.  Eligible healthcare providers must meet the criteria for "meaningful use" of "certified EHR technology" in order to qualify for significant incentives available under the HITECH Act.

The committee’s Privacy and Security Workgroup included access control, authentication, authorization and transmission of health data among the requirements that electronic health record systems must include by 2011 in order to meet the definition of "certified EHR technology."   Specifically for 2011, the Standards Committee approved the Workgroup's recommendation to require certified products to provide the capabilities necessary to support the HIPAA and ARRA security and privacy requirements and best practices for “meaningful use.”  The endorsed privacy and security standards will become more rigorous in 2013 and 2015.

You can find the spreadsheet of endorsed privacy and security standards here.

You can also view the presentation from the Workgroup here.

"Federal panel okays EHR security, privacy standards," Government Health IT (September 15, 2009).

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While the ONCHIT Advisory Committees continue to work on defining "meaningful use," the Certification Commission for Health Information Technology (CCHIT) plans to launch a new certification program for electronic health records systems based on the new requirements for such systems to qualify for incentive payments under the American Recovery and Reinvestment Act of 2009 (ARRA).  

On October 7, 2009, CCHIT will "offer a modular certification program called Preliminary ARRA 2011 that is limited to the standards for qualifying EHR technology under the American Recovery and Reinvestment Act (ARRA)."

More from the CCHIT press release:

The Commission has followed and analyzed the emerging recommendations of the health information technology advisory committees to the Office of the National Coordinator (ONC), and believes there is sufficient information to offer the preliminary ARRA certification now.

HHS criteria and standards are expected to be published by the end of 2009. Final rules on Meaningful Use are expected later in the Spring of 2010. If that process results in the introduction of new requirements, the Commission will offer vendors with preliminary certifications an incremental inspection at no additional fee to bring their certifications into alignment with the final rules. The Commission’s certification materials including criteria, test scripts and certification policies for both programs will be published at http://cchit.org on September 24. Applications for certification will open online on October 7.

"Certification Commission Launching 2011 Certification Programs In October," CCHIT press release (September 8, 2009).

"Federal committees to continue work on meaningful use," Healthcare IT News (September 11, 2009).

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Via HHS e-mail update:

The Office of the National Coordinator for Health Information Technology (ONC) is pleased to announce the availability of materials that are of immediate interest and use to stakeholders and potential applicants for the Health Information Technology Extension Program: Regional Centers Cooperative Agreement Program, and that are new or updated since the August 27, 2009 technical assistance telephone and web conference.

REVISED – Preliminary Application Template (Attachment I to the Funding Opportunity Announcement):  As discussed on the August 27th technical assistance public conference, the suggested template for applicants’ use in compiling and presenting the information required for the Preliminary Application has been updated to include the complete requirements established in the funding opportunity announcement and is now available from www.grants.gov and the Extension Program section of ONC’s website at http://healthit.hhs.gov/extensionprogram.

NEW – A complete transcript of the August 27th technical assistance conference is available for download from the Extension Program section of ONC’s website.  Please visit http://healthit.hhs.gov/extensionprogram to access detailed information about the conference, including the transcript and the presentation slides used during the call.

NEW/REVISED – Program-specific Frequently Asked Questions (FAQs) are now available on the Extension Program section of ONC’s website.  New FAQs are posted frequently, so potential applicants and other interested parties are encouraged to visit often.  Please visit http://healthit.hhs.gov/extensionprogram then scroll down and click on “Frequently Asked Questions”.

On the HIT Extension Program site, you can find the Funding Opportunity Announcement / Application Instructions document,  as well as a large FAQ section and the "Facts-At-A-Glance" summary. 

You can find the August 27th, 2009 presentation (PPT) here, and the transcript of that same presentation here.

"Health Information Technology Extension Program: Regional Centers Cooperative Agreement Program Update," HHS e-mail update (September 3, 2009).

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