HHS Awards $17.5 Million in Contracts Promoting Interoperability

Three organizations have won three-year contracts worth a total of $17.5 million the first year to help advance adoption of interoperable electronic health records, Department of Health and Human Services (HHS) officials announced last week. Funding for subsequent years is contingent upon congressional appropriations to HHS.

Research organization RTI International (Durham, N.C.) got the largest contract, an $11.5 million award, to address differences in state privacy and security laws that might hinder interoperability of health information. In partnership with the National Governors Association, RTI has created a group called the Health Information Security and Privacy Collaboration to carry out this task.

The American National Standards Institute (ANSI) has secured a $3.3 million contract to develop and test a process for harmonizing various standards for health-IT data to make sure present and future standards can support interoperability. Under the contract, ANSI will convene a government-sanctioned body called the Health Information Technology Standards Panel that will include a variety of standards development organizations, according to HHS. "I will expect that significant progress will be made before the end of next year," ANSI senior vice president Frances Schrotter said during a Thursday teleconference.

To create methods and standards for certifying the effectiveness of EHR products, HHS has awarded $2.7 million to the Certification Commission for Health Information Technology (CCHIT), a coalition of health-IT organizations and other private healthcare interests. The standards would define a "minimum bundle of features" that an EHR should have, according to national health-IT coordinator David Brailer, M.D.

"It's an immature marketplace, and the mark of an immature marketplace is that buyers don't really know what they are buying," CCHIT chairman Mark Leavitt, M.D., said during the teleconference, explaining the rationale behind a certification process.

Per the contractual requirements, CCHIT is expanding its membership to include safety-net healthcare providers, consumers, quality improvement organizations, public health agencies, and clinical researchers. (See http://tmlr.net/jump/?c=15601&a=296&m=3317&p=962974&t=164.)

The commission has until December to develop criteria for certifying ambulatory EHR software, after which time the American Health Information Community will debate the criteria and either recommend any changes to CCHIT or present the proposal to the HHS secretary. "It's our intention to have those criteria promulgated by summer," Leavitt said.

Work on inpatient EHR certification is set to begin next October, followed by a third phase related to network infrastructure in October 2007.

All the standards and certification processes will be voluntary. "We have no intention today to have any mandates or conditions for participation [in Medicare]," Brailer said.

Also last week, HHS published two proposed regulatory changes to promote the use of electronic prescribing and EHRs. One proposal would carve out an exception to Medicare anti-kickback regulations so hospitals, group medical practices, and other provider organizations to purchase e- prescribing technology and related services for physicians. The other plan calls for similar changes in the Stark rules prohibiting physician self-referral so that health systems can help doctors with EHR hardware, software, and training expenses.
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