Blumenthal Reviews ONC’s 2010 Accomplishments on ONC Blog

2010 ONC Update Meeting: Advancing the Dialogue on Health IT
Monday, December 27th, 2010 | Posted by: Dr. David Blumenthal on ONC’s Health IT Buzz blog and republished here by e-Healthcare Marketing.

Thank you to everyone who participated in the 2010 ONC Update on December 14-15, 2010 where we had the opportunity to discuss ONC’s strategies and programs, hear about your experiences in the field, assess progress to date, and get caught up on HITECH’s implementation. Video-recordings of the webcast are now available through the ONC website at

The 2010 ONC Update was held in conjunction with 2010 ONC Grantee Meeting which brought together for the first time the awardees of all of the ONC programs , including the Beacon Communities Program, Regional Extension Center Program, SHARP Program, State Health Information Exchange Program, and the many Workforce Development Programs.

This year, significant strides were made in health information technology. And for us, information technology has always been a means to an end, the end of improving health, improving the health system, making the lives of our fellow Americans better, making our nation’s health professionals and institutions able to live up to their aspirations, empowering Americans to have and take control of their own health and lives. These are the reasons why the Congress and the President enacted the HITECH Act and the reason that the Office of the National Coordinator exists today.

But, of course, there are many organizations and groups that have those high aspirations. Our unique contribution comes from a core insight that good intentions have to be powered by strong capabilities. And science and technology have created for us an enormously powerful new set of tools in the form of health information technology.

We are here to make sure that those tools are used fully to realize our collective aspirations. Information is the lifeblood of medicine. As health professionals and institutions, we are only as good as the information we have about the patients that we care for. Health IT is destined to be the circulatory system for that information in the decades to come.

The last several months have been a whirlwind of activity. And it is easy to forget how much we’ve accomplished. We established the meaningful use framework, one that I think is unprecedented in the history of electronic health information systems. No other country has laid out a similar framework for what can and should be accomplished using health information technology. And on January 3, the Centers for Medicare & Medicaid Services will launch the registration process for those who wish to participate in the Medicare and Medicaid EHR Incentive Programs.

We’ve issued a standards and certification regulation. As of this week, we have five certifying bodies that are available to certify electronic health records. They’ve certified more than 200 records and modules in the several months since they’ve been in existence.

Regional extension centers – 62 of them are working hard to provide hands-on assistance to those providers that need the most help in making this transition. As of this week, 30,000 physicians have already enrolled in these extension programs across the United States.

The State Health Information Exchange Program has provided 56 states and territories with planning grants. More than 20 of these states and territories have approved implementation plans, and new implementation plans are being approved every day.

Seventeen Beacon Communities are now in place. They didn’t exist a year ago. They are paving the way toward real improvements in health and health care in the communities they serve, leveraging health information technology. The SHARP Program is tackling new challenges through research and development.

And ONC’s Workforce Development Programs are preparing a whole new workforce and creating new jobs to support the transformation of our health care system through the use of information technology. To date, we have seen almost 2,300 new enrollees in community college programs and close to 400 in University‑based Training Programs focused on health information technology. And we are well on our way in these very early stages toward meeting that target of 10,000 new health professionals trained annually during the lifetime of the program.

In addition to our grants, we have dozens of contracts that are supporting programs like the Nationwide Health Information Network. And our Health IT Policy Committee and Health IT Standards Committee continue to provide enormously valuable guidance on the many policies and standards that are needed to support execution against our mission.

All of these efforts not only play a critical role in our strategy related to the improvement of health and health care through information technology, but also provide the foundation for health systems change and upcoming reforms in how we deliver and pay for care.

As we look to 2011, there will be many challenges. Driving change is hard. And it takes leadership, commitment and the ability to move forward – despite the many obstacles that each of you will encounter. I hope your sense of contributing something unique to health care and the American people – for most certainly you are – balances the incredibly hard work that you are undertaking. Someday you will look back and realize that you were present at the creation of something big.

Thanks again, and we look forward to our continued collaboration in the new year.
###To comment directly on ONC’s Health IT Buzz Blog, click here.
See Blumenthal Letter #22 on e-Healthcare Marketing.

Blumenthal Letter #22: Ready for Jan 3 EHR Incentives Registration?

Registration for EHR Incentive Programs
Starts January 3, 2011: Are You Ready?

Dr. David Blumenthal

Dr. David Blumenthal

A Message from Dr. David Blumenthal, the National Coordinator for Health Information Technology
December 27, 2010

Published by ONC on 12/27/2010 and republished here.

The New Year is just around the corner, and so is another milestone in our nation’s work to improve health care through health information technology. Starting on January 3, 2011, eligible health care professionals, hospitals, and critical access hospitals may register to participate in the Medicare and Medicaid EHR Incentive Programs.

This is an auspicious time. Nearly two years ago, the Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009, was signed into law. Since then Department of Health and Human Services (HHS) agencies like the Office of the National Coordinator for Health Information Technology (ONC), the Centers for Medicare & Medicaid Services (CMS), the Office for Civil Rights (OCR), and others have implemented HITECH policies and programs to help providers adopt and achieve meaningful use of certified electronic health record technology and ensure that electronic health information remains private and secure.

[See Blumenthal's review of 2010, originally posted on ONC's Health IT Buzz blog.]

Why Become a Meaningful User?

Qualify for financial incentives from the federal government
Eligible professionals who demonstrate meaningful use have the opportunity to receive incentive payments through the Medicare and Medicaid EHR Incentive Programs—up to $44,000 from Medicare, or $63,750 from Medicaid.  Under both Medicare and Medicaid, eligible hospitals may receive millions of dollars for implementing and meaningfully using certified EHR technology. Providers can get started now with the help of financial incentives from the federal government. If they wait, those incentives may not be available. And financial penalties are scheduled to take effect in five years. 

Build a sustainable medical practice
The next generation of health care professionals will expect and demand that their own medical facility home have a state-of-the-art information system.  Becoming a meaningful user of electronic health records will allow providers who are building their practices to recruit and retain talented young clinicians.

Improve the safety and quality of health care 
The meaningful use of electronic health records will help health care providers and hospitals offer higher quality and safer care. By adopting electronic health records in a meaningful way, providers and hospitals can:

  • See the whole picture. All of a patient’s health information—medical history, diagnoses, medications, lab and test results—is in one place. Providers don’t have to settle for a snapshot when they can have the entire album.
  • Coordinate care. Providers involved in a patient’s care can access, enter, and share information in an electronic health record.
  • Make better decisions. With more comprehensive health information at their fingertips, providers can make better testing, diagnostic, and treatment decisions.
  • Save time and money. Providers who have implemented electronic health records say they spend less time searching for paper charts, transcribing, calling labs or pharmacies, reporting, and fixing coding errors.

ONC and CMS: Here To Help

Registration for the incentive programs may be close at hand, but so is assistance. If you need help in registering for the Medicare and Medicaid EHR Incentive Programs or selecting a certified EHR system, ONC and CMS have resources and services to help you.

  • The Medicare and Medicaid EHR Incentive Programs website contains educational resources and fact sheets with information to help eligible professionals and hospitals adopt, implement, and upgrade certified EHR technology and demonstrate meaningful use to receive EHR incentive payments.
  • Regional Extension Centers, which cover every region of the country, provide on-the-ground technical assistance to health care providers working to adopt and meaningfully use certified EHR technology.
  • The Health IT Workforce Development Program prepares skilled workers for new jobs in health IT.

Connecting to Your Community
ONC also has other programs in place to help advance the meaningful use of certified EHR technology and health information exchange:

As 2010 comes to a close, we are well on our way as a nation to achieving the benefits of widespread adoption of EHRs. If you haven’t made any preparations to register to receive incentive payments, I encourage you to get started now. Resolve today to become a meaningful user in 2011.

David Blumenthal, MD, MPP
National Coordinator for Health Information Technology 
The Office of the National Coordinator for Health Information Technology (ONC) encourages you to share this information as we work together to enhance the quality, safety and value of care and the health of all Americans through the use of electronic health records and health information technology.

For more information and to receive regular updates from the Office of the National Coordinator for Health Information Technology, please subscribe to our Health IT News list.

Health IT Special Issue of The American Journal of Managed Care: Dec 2010

AJMC Publishes Health Information Technology Special Issue Online Dec 20, 2010
“Featuring scholarly articles and perspectives from policymakers, payers, providers, pharmaceutical companies, health IT vendors, health services researchers, patients, and medical educators, this [December 2010 special] issue of  The American Journal of Managed Care is a reflection” of  “the  dramatic growth of interest in the potential for HIT to improve health and healthcare delivery,” writes Sachin H. Jain, MD, MBA and David Blumenthal, MD, MPP in their introductory article titled “Health Information Technology Is Leading Multisector Health System Transformation.”  Both Jain and Blumenthal are with the Office of the National Coordinator for Health Information Technology.

Authors of 23 Articles in Special Issue
Sachin H. Jain, MD, MBA; and, David Blumenthal, MD, MPP; Cynthia L. Bero, MPH; and Thomas H. Lee, MD; Aaron McKethan, PhD; and Craig Brammer; John Glaser, PhD; Pete Stark; Newt Gingrich, PhD, MA; and Malik Hasan, MD; James N. Ciriello, MS; and Nalin Kulatilaka, PhD, MS; Seth B. Cohen, MBA, MPA; Kurt D. Grote, MD; Wayne E. Pietraszek, MBA; and Francois Laflamme, MBA; Amol S. Navathe, MD, PhD; and Patrick H. Conway, MD, MSc; Reed V. Tuckson, MD; Denenn Vojta, MD; and Andrew M. Slavitt, MBA; Marc M. Triola, MD; Erica Friedman, MD; Christopher Cimino, MD; Enid M. Geyer, MLS, MBA; Jo Wiederhorn, MSW; and Crystal Mainiero; Nancy L. Davis, PhD; Lloyd Myers, RPh; and Zachary E. Myers; Bryant A. Adibe, BS; and Sachin H. Jain, MD, MBA; Spencer S. Jones, PhD; John L. Adams, PhD; Eric C. Schneider, MD; Jeanne S. Ringel, PhD; and Elizabeth A. McGlynn, PhD; Jeffrey L. Schnipper, MD, MPH; Jeffrey A. Linder, MD, MPH; Matvey B. Palchuk, MD, MS; D. Tony Yu, MD; Kerry E. McColgan, BA; Lynn A. Volk, MHS; Ruslana Tsurikova, MA; Andrea J. Melnikas, BA; Jonathan S. Einbinder, MD, MBA; and Blackford Middleton, MD, MPH, MS;Alexander S. Misono, BA; Sarah L. Cutrona, MD, MPH; Niteesh K. Choudhry, MD, PhD; Michael A. Fischer, MD, MS; Margaret R. Stedman, PhD; Joshua N. Liberman, PhD; Troyen A. Brennan, MD, JD; Sachin H. Jain, MD, MBA; and William H. Shrank, MD, MSHS; Amir Dan Rubin, MBA, MHSA; and Virginia A. McFerran, MA; Fredric E. Blavin, MS; Melinda J. Beeuwkes Buntin, PhD; and Charles P. Friedman, PhD Robert D. Hill, PhD; Marilyn K. Luptak, PhD, MSW; Randall W. Rupper, MD, MPH; Byron Bair, MD; Cherie Peterson, RN, MS; Nancy Dailey, MSN, RN-BC; and Bret L. Hicken, PhD, MSPH; Jeffrey A. Linder, MD, MPH; Jeffrey L. Schnipper, MD, MPH; Ruslana Tsurikova, Msc, MA; D. Tony Yu, MD, MPH; Lynn A. Volk, MHS; Andrea J. Melnikas, MPH; Matvey B. Palchuk, MD, MS; Maya Olsha-Yehiav, MS; and Blackford Middleton, MD, MPH, MSc; Emily Ruth Maxson, BS; Melinda J. Beeuwkes Buntin, PhD; and Farzad Mostashari, MD, ScM; Daniel C. Armijo, MHSA; Eric J. Lammers, MPP; and Dean G. Smith, PhD; Katlyn L. Nemani, BA.

Look for an upcoming post on e-Healthcare Marketing reviewing this special issue of AJMC.

Supplemental Challenge Funding to State HIE Programs: FAQs, Slides, Audio from Tech Assistance Call

Supplemental Challenge Funding to State HIE  Programs
FAQs, Slides, Audio from Technical Assistance Conference Call

Excerpted from ONC sites on Dec 23, 2010

  • Closing Date for Applications from State HIEs: January 05, 2011 at 5:00 PM, EST
  • Estimated Total Program Funding: $16,296,562
    Technical Assistance Call
Supports awards in five challenge areas to enable nationwide health information exchange:
§Achieving health goals through health information exchange
§Improving long-term and post-acute care transitions
§Consumer-mediated information exchange
§Enabling enhanced query for patient care
§Fostering population-level analytics

PDF Version

1. How do I determine if my organization is an eligible applicant for this funding opportunity?
Current direct award recipients of the State HIE Cooperative Agreement program are eligible to apply for this funding opportunity. To determine if your organization is the eligible entity in your state, review the most recent Notice of Grant Award for the State HIE Cooperative Agreement Program. The direct award recipient is listed in Box 11 “Recipient Organization.” There are 56 eligible organizations for this funding opportunity.

2. Can we apply for funding to support an unfunded project we discussed in our State Plan submitted under the State HIE Cooperative Agreement program?
Funds under this announcement cannot be used to fund activities already presented in the Strategic and Operational Plans and funded as part of the scope of work under the State HIE Cooperative Agreement. Funds cannot be used to supplant or replace current public or private funding of projects. Funds also cannot be used to supplant ongoing or usual activities of any organization involved in the project. However, if a project was presented in the State Plan but clearly not funded with public or private monies and is not part of ongoing scope of work of an affiliated organization, it may be submitted as part of a project under this funding opportunity.

3. As part of our proposed project, we will contract with a vendor to develop software for use by providers in the project. Please clarify what is meant by “Any IT system components (e.g., software, data models, etc.) developed by the awardees under this funding opportunity will be made available to any state.” Does this mean any IT development must be open source?
No, IT development does not have to be open source. The purpose of this program is to fund innovative technology development and approaches in pilot sites that will then be shared, reused, and leveraged by other states and communities to increase nationwide interoperability. Anything developed with funds under this cooperative agreement must be accessible and usable outside of the pilot site. Successful awardees must demonstrate how the tools, systems, or models developed under this cooperative agreement will be easily adapted and implemented beyond the pilot scope of work.

4. Can we propose a project with a geographic area that overlaps with a Beacon awardee?
While nothing in this funding announcement prohibits an overlap in targeted geographic areas, the scope of work must be different for both projects; funds under this announcement cannot be used to supplant or replace current public or private funding.

5. How should the budget documentation be presented in the application?
Applicants are required to submit a one-year budget for each year of the project period. Please remember that the challenge grants period of performance (project period) ends at the
same time as the current cooperative agreement. Therefore, budgets should only be submitted for the remaining three years in the cooperative agreement since the project periods will be married. Applicants are suggested to use the format included as Appendix A of the Funding Opportunity Announcement. Applicants are also encouraged to refer to Appendix J of the State HIE Cooperative Agreement FOA, which provides an example of the level of detail sought.
A combined multi-year Budget Narrative/Justification, as well as a detailed Budget Narrative/Justification for each year of potential grant funding is also required. Instructions were provided in Appendix I of the State HIE Cooperative Agreement FOA that pertain to completing the SF 424.

6. Can the eligible entity apply for this funding opportunity and then contract or subgrant the substantive work to an outside entity?
The direct award recipient must have direct oversight and accountability for the project. When preparing the budget, the six contractual elements required to be submitted when subawarding a substantial portion of the programmatic work must be included. These are:
I. Name of Contractor: Who is the contractor
II. Method of Selection: ? Identify the name of the proposed contractor and indicate whether the contract is with an institution or organization.
How was the contractor selected
III. Period of Performance: ? State whether the contract is sole source or competitive bid. If an organization is the sole source for the contract, include an explanation as to why this institution is the only able to perform contract services.
How long is the contract period
IV. Scope of Work: ? Specify the beginning and ending dates of the contract.
What will the contractor do
V. Method of Accountability: ? Describe in outcome terms the specific services/tasks to be performed by the contractor as related to the accomplishment of program objectives. Deliverables should be clearly defined.
How will the contractor be monitored
VI. Itemized budget and justification: Provide an itemized budget with appropriate justification. If applicable, include any indirect cost paid under the contract and indirect cost used. Provide a copy of the negotiated indirect cost rate agreement. ? Describe how the progress and performance of the contractor will be monitored during and on close of the contract period. Identify who will be responsible for supervising the contract.

7. Can my state’s eligible entity request funding for more than one challenge theme?
Eligible entities may submit one application per challenge theme; therefore, no more than five applications are permitted from each eligible entity. Each application must clearly indicate the challenge theme addressed. Approximately 10 awards will be made; it is possible for an eligible entity to receive more than one award.

8. Can letters of commitment to the State Health Information Exchange Cooperative Agreement be used to demonstrate commitment to this initiative?
Yes. However, applicants are strongly encouraged to include letters of commitment from key program partners and stakeholders that are specific to the project proposed in the application.

9. Some staff supported under the State HIE Cooperative Agreement would be proposed in our application to support the challenge project. Is that allowable? Can we rebudget our State HIE Cooperative Agreement to reflect the staffing shifts?
Applicants are advised that the scope of work and budget for this application must be separate from the funded scope of work in the State Health Information Exchange cooperative agreement. In the event that staff may overlap, please note that ONC will develop a process for successful applicants to finalize the scope of work, staffing, and budget to ensure that successful performance of the Health Information Exchange cooperative agreement is not jeopardized and to assure that funds are not supplanted.

PDF of Funding Announcement
Health Information Exchange Challenge Program Funding Opportunity Announcement

See previous e-Healthcare Marketing post on Challenge Program.

Colleen Woods Asks “Where are the NJ Healthcare Innovators?!!”

From: Colleen Woods, NJ Health IT Coordinator
To: New Jersey Healthcare Innovators,
NJ Health IT Community
Re: Calling for Innovations for Supplemental ONC Funding
Date: Dec 21, 2010
High Priority
Most of you are aware that the Office of the National Coordinator issued a supplemental funding opportunity to the State Health Information Exchange Cooperative Agreement Program.  As required, on December 10th,2010,  I responded that New Jersey would apply for the supplemental funding, knowing that we have many exciting projects in place that could be advanced with just a bit of additional funds.

There are five challenge “themes” that the feds view as potential barriers to full national health information exchange. They are seeking innovative ideas/solutions from those of you who know healthcare delivery the best.  The themes are:
  • Achieving Health Goals through Health Information Exchange
  • Improving Long Term and Post Acute Care Transitions
  • Consumer Mediated Information Exchange
  • Enabling Advance Query for Patient Care
  • Fostering Distributed Population-Level Analytics

For more information please see a PDF of the  ONC’s funding announcement:

Or to see all the funding documents, go to

I know there are a lot of good ideas and projects already underway that would qualify for this funding opportunity. (Jeff, Becky, Jim, Tom, Dave, Tom, Linda, Lou, Judy, Neal, Al, Bob et al…..) , but the award requires a quick response.  Applications need to be sent to by the NJ State Coordinator’s Office ONC by January 5th, 2011. I would proud to submit any ideas you have that would meet the ONC challenge.  Please feel free to call me to discuss.

My best wishes to you and your families for a Happy Holiday Season!


Colleen Woods
NJ Health IT Coordinator
Governor’s Office

Synopsis of the Supplemental State HIE Challenge Program
“This funding announcement for the Health Information Exchange Challenge Program encourages breakthrough progress for nationwide health information exchange in five challenge areas identified as key needs since Federal and State governments began implementation of the HITECH Act. The awards will fund the development of technology and approaches that will be developed in pilot sites and then shared, reused, and leveraged by other states and communities to increase nationwide interoperability. The five themes include: 1. Achieving health goals through health information exchange 2. Improving long-term and post-acute care transitions 3. Giving patients access to their own health information 4. Developing tools and approaches to search for and share granular patient data (such as specific lab results for a given time period) 5. Fostering strategies for population-level analysis Awards will range between $1 million and $2 million each, and will be in the form of supplemental funding to State Health Information Exchange Cooperative Agreements, which have provided approximately half a billion dollars to states and State designated entities to enable health information exchange. Funding for this initiative is approximately $16 million which ONC anticipates will support 10 awards.”
–Synopsis from

Beacon Community Videos: ‘Improving Health Through Health Information Technology’ Posted on ONC site

‘Improving Health Through Health Information Technology’
Video, description and Web site of each Beacon Community Program Awardee by the Office of the National Coordinator(ONC)  for Health IT’ was posted on ONC’s site on December 8.

“The Beacon Community Cooperative Agreement Program provides funding to 17 selected communities throughout the United States that have already made inroads in the development of secure, private, and accurate systems of electronic health record (EHR) adoption and health information exchange. The Beacon Program will support these communities to build and strengthen their health information technology (health IT) infrastructure and exchange capabilities to improve care coordination, increase the quality of care, and slow the growth of health care spending.”

Beacon Community Program

Beacon Community Program

These are excerpts accessed on December 9, 2010:

The 17 Beacon Communities will focus on specific and measurable improvement goals in the three vital areas for health systems improvement: quality, cost-efficiency, and population health, to demonstrate the ability of health IT to transform local health care systems. The goals vary according to the needs and priorities of each community. For instance, some communities will focus in the care for chronic conditions such as asthma, heart failure, and diabetes to illustrate how costs can be reduced and patient care improved through the collection, analysis, and sharing of clinical data.

Beacon Communities

Listed below are the 17 Beacon Communities, their awards, and snapshot of their goals. To view further information about a specific Beacon Community, click the name of the community.

Beacon Community

Award Amount


Bangor Beacon Community, Brewer, ME $12,749,740 Improve the health of patients with diabetes, lung disease, heart disease, and asthma by enhancing care management; improving access to, and use of, adult immunization data; preventing unnecessary ED visits and re-admissions to hospitals; and facilitating access to patient records using health information technology.
Beacon Community of the Inland Northwest, Spokane, WA $15,702,479 Increase care coordination for patients with diabetes in rural areas and expand the existing health information exchange to provide a higher level of connectivity throughout the region.
Central Indiana Beacon Community, Indianapolis, IN $16,008,431 Expand the country’s largest Health Information Exchange to new community providers in order to improve cholesterol and blood sugar control for diabetic patients and reduce preventable re-admissions through telemonitoring of high risk chronic disease patients after hospital discharge.
Colorado Beacon Community, Grand Junction, CO $11,878,279 Demonstrate how costs can be reduced and patient care improved, through the collection, analysis, and sharing of clinical data, and the redesign of primary care practices and clinics.
Crescent City Beacon Community, New Orleans, LA $13,525,434 Reduce racial health disparities and improve control of diabetes and smoking cessation rates by linking technically isolated health systems, providers, and hospitals; and empower patients by increasing their access to Personal Health Records.
Delta BLUES Beacon Community, Stoneville, MS $14,666,156 Improve access to care for diabetic patients through the meaningful use of electronic health records and health information exchange by primary care providers in the Mississippi Delta, and increase the efficiency of health care in the area by reducing excess health care costs for patients with diabetes through the use of electronic health record.
Greater Cincinnati Beacon Community, Cincinnati, OH $13,775,630 Develop new quality improvement and care coordination initiatives focusing on patients with pediatric asthma, adult diabetes, and encouraging smoking cessation, and provide better clinical information and IT “decision support” tools to physicians, health systems, federally qualified health centers, and critical access hospitals.
Greater Tulsa Health Access Network Beacon Community, Tulsa, OK $12,043,948 Leverage broad community partnerships with hospitals, providers, payers, and government agencies to expand a community-wide care coordination system, which will increase appropriate referrals for cancer screenings, decrease unnecessary specialist visits and (with telemedicine) increase access to care for patients with diabetes.
Hawaii County Beacon Community, Hilo, HI $16,091,390 Improve the health of the Hawaii Island residents through implementation of a series of healthcare system improvements and interventions across independent hospitals, physicians and physician groups. Engaging patients in their own healthcare is also a primary focus.
Keystone Beacon Community, Danville, PA $16,069,110 Establish community-wide care coordination through the expanded availability and use of health information technology for both clinicians and patients in a five-county area to enhance care for patients with pulmonary disease and congestive heart failure.
Rhode Island Beacon Community, Providence, RI $15,914,787 Improve the management of care through several health information technology initiatives to support Rhode Island’s transition to the Patient Centered Medical Home model, which create systems to measure and report processes and outcomes that drive improved quality, reduce health care costs, and improve health outcomes.
San Diego Beacon Community, San Diego, CA $15,275,115 Expand electronic health information exchange to enable providers to improve medical care decisions and overall care quality, to empower patients to engage in their own health management, and to reduce unnecessary and redundant testing.
Southeast Michigan Beacon Community, Detroit, MI $16,224,370 Make long-term, sustainable improvements in the quality and efficiency of diabetes care through leveraging existing and new technologies across health care settings, and providing practical support to help clinicians, nurses, and other health professionals make the best use of electronic health data.
Southeastern Minnesota Beacon Community, Rochester, MN $12,284,770 Enhance patient care management, reduce costs associated with hospitalization and emergency services for patients with diabetes and childhood asthma, and reduce health disparities for underserved populations and rural communities.
Southern Piedmont Beacon Community, Concord, NC $15,907,622 Increase use health information technology, including health information exchange among providers and increased patient access to health records to improve coordination of care, encourage patient involvement in their own medical care, and improve health outcomes while controlling cost.
Utah Beacon Community, Salt Lake City, UT $15,790,181 Improve the management and coordination of care for patients with diabetes and other life-threatening conditions, decrease unnecessary costs in the health care system, and improve public health.
Western New York Beacon Community, Buffalo, NY $16,092,485 Expand the Western New York network, close gaps in service, and improve health outcomes for patients with diabetes.

New Series of ONC Fact Sheets on EHR, HIE Programs and Health IT Topics

ONC Fact Sheets Page
New Information Pages/Sheets published by ONC on 12/3/2010.

'Get The Facts' Fact Sheet

'Get The Facts' Fact Sheet

 On December 3, 2010, the Office of the National Coordinator (ONC) for Health IT published seven new one-page Fact Sheets on a range of their Health IT initiatives in both HTML and PDF formats. In addition ONC published links to two Health IT programs, one from Department of Health and Human Services in 2007, and the other updated in September 2009 from AHRQ. 

 The seven ONC one-pagers appear to be the first shots of a more extensive PR campaign to get the word out  beyond those “already in the know,” to those physicians, healthcare professionals, and the general public who have not been following HITECH, ONC, and the state-level  Health IT programs as closely as the early adopters. They will also provide materials for the regional extension centers to distribute to physicians and clinicians.

About Electronic Health Records

HITECH Programs
     Get the Facts about

Health IT Topics

Links to HTML versions of the seven ONC Fact Sheets on e-Healthcare Marketing.
In addition to the links above which go to the ONC Web site, the seven Fact Sheets are available in HTML on e-Healthcare Marketing.

1. Electronic Health Records: Advancing America’s Health Care
2. Using EHRs to Improve Health Care in Your Practice and Community
3. Beacon Community Program
4. State Health Information Exchange
5. HIT Extension Program (Regional Extension Centers)
6. SHARP (Strategic Health IT Advanced Research Projects) Program
7. Health IT Workforce Development Program

ONC Fact Sheet: Beacon Community Program

ONC Fact Sheet: Get the Facts on Beacon Community Program
Published on ONC site 12/3/2010.

Improving the nation’s health care through health information technology (health IT) is a major initiative for the U.S. Department of Health and Human Services (HHS). The Office of the National Coordinator for Health Information Technology (ONC), the Centers for Medicare & Medicaid Services (CMS), the Office for Civil Rights (OCR), and other HHS agencies are working together to assist health care providers with the adoption and meaningful use of electronic health records.

ONC’s Beacon Community Program will help guide the way to a transformed health care system. The program will fund more than a dozen demonstration communities that have already made inroads into the adoption of health information technology (health IT), including electronic health records and health information exchange. Beacon Communities will advance new, innovative ways to improve care coordination, improve the quality of care, and slow the growth of health care spending.

About the Beacon Communities
The goal of the Beacon Community Program is simple: to show how health IT tools and resources can contribute to communities’ efforts to  make breakthrough advancements in health care quality, safety, efficiency, and in public health at the community level and to demonstrate that these gains are sustainable and replicable.

In May 2010, ONC awarded 15 grants totaling $220 million to communities across the country that are leading the way in health IT. Two additional grants totaling $30 million were awarded in September 2010. Communities will use funding to:

  • Build and strengthen their health IT infrastructure and exchange capabilities
  • Demonstrate how meaningful use of electronic health records and health IT can lead to  improvements in health care quality, reductions in unnecessary costs, and gains in public health
  • Provide support and guidance to other communities for achieving meaningful use and measurable health care improvements and cost savings

Communities will work with other Health Information Technology for Economic and Clinical Health (HITECH) Act programs, including the Regional Extension Center Program and State Health Information Exchange Program, to:

  • Develop and disseminate best practices for adopting and using health IT to improve quality and cost outcomes
  • Foster national goals for widespread meaningful use of health IT

The Beacon Community Program will also support the development of secure nationwide health information exchange strategies to improve the health care of all Americans.

The HITECH Act establishes programs to accelerate the meaningful use of health IT. The aim is to improve both the health of Americans and the performance of our nation’s health care system.

For More Information About:

Download Get the Facts about Beacon Community Program [PDF - 270 KB]

ONC Fact Sheet: Strategic Health IT Advanced Research Projects (SHARP) Program

ONC Fact Sheet: Strategic Health IT Advanced Research Projects (SHARP) Program
Published on ONC site 12/3/2010.

The nation has made great strides towards a technologically advanced health care system that offers improved quality, safety, and efficiency. However, there remain challenges and barriers to the adoption of electronic health records and other forms of health information technology (health IT).

The Office of the National Coordinator for Health Information Technology has funded the Strategic Health IT Advanced Research Projects (SHARP) program to directly confront these challenges.

The SHARP program supports the discovery of “breakthrough” research findings that will accelerate the nationwide use of health IT and will support dramatic improvements in health care.

About the SHARP Program
SHARP program grants have been awarded to four universities and health care organizations that are leading the way in health IT research and innovation. Each awardee has received $15 million to lead a large collaborative of diverse health care stakeholders, conducting research in one of the following areas:

  • Security and Health Information Technology 

Goals:Develop technologies and policies to increase security safeguards and reduce risk; develop technologies to build and protect public trust

  • Patient-Centered Decision-Making Support

Goals:Use the power of health IT to integrate and support doctors’ reasoning and decision-making as they care for patients

  • Health Care Application and Network Design

Goals:Create new and improved system designs to achieve information exchange and ensure privacy and security of electronic health information

  • Secondary Use of EHR Information

Goals:Develop strategies for using information stored in electronic health records for improving the overall quality of health care while maintaining the privacy and security of protected health information

To accelerate health IT adoption, the universities and health care organizations will also work with technology developers, vendors, and health care providers to apply their findings to the practice of medicine.

For More Information About:

Download Get the facts about SHARP Program [PDF - 276 KB]

ONC Presents Personal Health Records Roundtable: Report from Washington, DC

Day in Washington, DC at PHR Roundtable
This post was blogged during the meeting, and may be reviewed and corrected in the next few days. Please see links to the videos at the end of this post.

PHR Roundtable, Washington, DC
PHR Roundtable, Washington, DC

Washington, DC, (December 3, 2010)–The meeting is getting started today with introduction by Joy Pritts, Chief Privacy Officer, HHS/Office of National Coordinator (ONC)  for Health IT, and welcoming remarks by the National Coordinator David Blumenthal, MD. Dr. Blumenthal is speaking about the process of innovation spurred by HITECH, and not directed by ONC. “The patient and consumer come first” is one of the guiding principles for ONC according to Blumenthal, and the consumer’s faith in the privacy and security of their patient information is critical to the HITECH initiatives. Part of the reason for this privacy and security hearing is to encourage innovation and transparency, one of the over 200 open meetings held already by ONC.

Pritts also notes that the Health IT initiatives are focused on patients as the center of healthcare. Now we’re on to role of “Meaningful Use,” providing patients with electronic version of their health records. HITECH Act requires that ONC study privacy and security with regard to those records, in addition to the current requirements. Pritts asks  how are we going to strike right balance of innovation and maintain the use of that information for intended purposes.

First panel will provide some historical perspective and is focused on origins, development, and security practices. Tim McKay, Kaiser Permanente, provides brief on Kaiser’s use of electronic health records and personal health records which began in ’90s as regional Kaiser initiatives, and took on national scope in late 90s. Currently Kaiser has roled out EHR and PHRs. Is this patient portal or PHR? And the answer is “yes.”

Lori Nichols, Director, HInet, is director of Whatcom Health Information Network in Whatcom County, Washington state. Per their Web site, HInet is an inclusive, secure, community-wide, healthcare intranet in Whatcom County. Using various broadband technologies, it connects hospital, payors, physician offices, and community health services.  It also provides connection to the Internet.”

George Steinberg, MD, president and ceo of ActiveHealth Management, a company started with venture capital and now owned as separate company by Aetna. Started as decision support for physicians, and grew to consumer tool. Consumer PHR contains decision support to respond to consumer entering data dynamically.

Colin Evans, CEO of Dossia, a PHR company describes how the firm was founded for employers for use by their employees for safety and care coordination. Use by employees ranges from 10% to 80% based on whether company is offering incentives or not. Evans claims that data is owned by consumers. In some cases there are conflicts between HIPAA regulations and FTC regulations with regard to online protected health information.

George Scriban, Sr. Program Manager, Microsoft HealthVault, speaks about consumer interaction with healthcare as something that goes much beyond interaction with clinicians. HealthVault is cloud-based location for fragments of health information gathered from full-range of entities, improving the boxes of a patient’s information located throughout the house and clinical offices. HealthVault is not a PHR, but a personal health information platform, per Sriban, one of Microsoft’s constant refrains.

McKay of Kaiser Permanente is starting a large initiative to expand Identity Services, to maintain their information even if they leave Kaiser plans.

ONC moderator Kathy Kenyon asks “Do patients ever pay for a PHR?” of those represented. Panel answer is no.

Panel moves on to revenue sources and sustainability of consumers are paying.
Dossia: Support by employers.
Kaiser: From consumer dues. Savings comes from cost savings in employer time saved. In 2006, about 20% of Kaiser patient population used PHR, and risen to 60% in 2010. Patients viewing their patient information alone raises safety of patients.
HInet: no charge for consumers, currently grant-funded, but there will be a  charge for Smartphone use. Employers and payers are noticeably absent from financial support, and this is due in large part because consumers don’t want insurance companies and employers to view their personal health information.
Microsoft: HealthVault is a free service, that is part of the larger health services unit with services offered commercially, the revenue source.
ActiveHealth: Paying customers are the employers, with PHR one of services offered. ActiveHealth is offered to 8 million Aetna members and close to 2 million non-Aetna users, with another 700,ooo non-Aetna users expected to be announced shortly. Non-Aetna users are based on offering to employers (need to confirm who these non-Aetna users are).

Additional discussion on opportunity of health plan or employer viewing health information on PHRs. Dossia says no to employers. HInet users can see who has and has not accessed their share plan PHR  since the last time the consumer viewed their PHR.

Lack of physician support and interoperability of electronic health records appears to be a limiting factor to actual use of PHRs.

New Forms, New Audiences, New Challenges–Second Panel
Wil Yu, Special Assistant of Innovation and Research, ONC, is moderating panel on PHR’s new forms, audiences, and challenges. Stephen Downs, Asst. Vice President, Robert Woods Johnson Foundation, is responsible for Project Health Design, a 4 1/2 year old program to reinvent PHRs; Open Notes, where patients can view their physician’s notes; and Blue Button.  Downs offered three themes: separating apps from data, expanding definition of healthcare–ODL, observations of daily living, and sharing data.

Darcy Gruttadaro, Director, NAMI Child & Adolescent Action Center. NAMI is National Alliance on Mental Illness. Since launch of its social networking site in April 2010, NAMI has gained 1,300 users for social networking site, modeled somewhat after facebook. Realizes there are a lot more security issues than she initially realized. NAMI social networking site:

Description of NAMI’s social networking site:
“StrengthofUs is an online community designed to empower young adults through resource sharing and peer support and to build connections for those navigating the unique challenges and opportunities in the transition-age years.  StrengthofUs provides opportunities for you to connect with your peers and offer support, encouragement and advice and share your real world experiences, personal stories, creativity, resources and ultimately, a little bit of your wonderful and unique self. It is a user-generated and user-driven community; so basically it’s whatever you make it. Everything here has been developed and created by and for young adults with you specifically in mind…because we think you’re worth it! We hope every time you visit, you find hope, encouragement, support and most of all, the strength to live your dreams and goals.”

John Moore, of Chilamrk Research, says the terms EHR and PHR create an artificial barrier. “People could care less” about PHR as file cabinet. Unified or collaborative health records need to be actionable Moore said. Moore made a great segue to Gail Nunlee-Bland, MD, interim chief of Endocrinology and Director of Diabetes Treatment Center, Howard University, referencing his Chilmark post “Smashing Myths & Assumptions: PHR for Urban Diabetes Care.” That post is certainly worth reading, and Nunlee-Bland mentioned that 85% of their inner-city patients have access to computer and Internet, which is not what the “general knowledge” says. While Howard’s PHR users are concerned about privacy, only about 5% of their potential users, have opted not to use it because of privacy issues.

Douglas Trauner, CEO, of, asked what do we need to do for overcoming healthcare, privacy and security issues.’s web site describes  itself: “ provides easy-to-use tools for tracking your life for a variety of topics including health, nutrition, fitness, and medicines—all within a familiar calendar format. Through this free, anonymous service, you gain a comprehensive view of your health that helps you identify areas of improvement and goal-setting.”

There’s a lot of discussion about sharing information among consumer/patient users. Panelists offer range of views about how much consumers are concerned about privacy and security. There’s a great deal of discussion about trust, including Downs’ tale of a teenager being quite willing to share lots of personal information with their 80 friends, but not their parents.

Privacy and Security of Identifiable Health Information in PHRs and Related Technologies: Expectations and Concerns – Panel Three
Joy Pritts is moderating the first afternoon panel session. Tresa Undem, VP, Lake Research Partners, said consumers are generally unaware of PHRs, based on a year-old study when only 7% reported using a PHR. Lee Tien, from West-coast based Electronic Frontier Foundation, specializes in privacy laws, not healthcare privacy. New reports from recent FTC survey shows how little public knows about privacy issues. Josh Lemieux, director of Personal Health Technology, Markle Foundation, based on six surveys, said public likes the idea of personal health records, and also say they want privacy practices.

Robert Gellman, reported on privacy issues and concerns about data leakage based on long experience, starting with working on the Hill. Strong need to define of what we’re trying to do:

Key data research resources for this panel:
Conducted by Lake Research Partners
Consumer surveys of privacy and personal health records

Tien says there is a basic ignorance among consumers and patients of actual privacy policies and implications. Based on work by Microsoft privacy expert, Tien cited the change of attitude or reality of public and private areas.  It used to be that privacy was the default reality for people and it was hard to get known publicly. Currently, public knowledge of details about people is the default reality, while maintaining privacy is a challenge.

Perspectives on Privacy and Security Requirements for PHRs and Related Technologies — Panel 4
Moderator is Leslie Francis, Distinguished Professor of Law and Philosophy at University of Utah.

Adam Greene, JD, Senior Health IT & Privacy Specialist, HHS Office of Civil Rights explained that HIPAA jurisdiction does not follow the data. OCR oversees three kinds of covered entities plus direct jurisdiction of business associates. Greene asked and answered:  Are PHRs covered by HIPAA? Sometimes–yes when furnished by covered entity or provided on behalf of covered entity.

Loretta Garrison, JD, Senior Attorney, Bureau of Consumer Protection, FTC uses unfairness and deceptive prongs to protect consumers. Bureau is claims driven. On December 1, 2010, FTC issued Privacy Report and recommended a privacy framework for consumers, businesses, and policymakers.
Here’s the link on press release.
Here’s link to actual report titled “Protecting Consumer Privacy in an Era of Rapid Change: A Proposed Framework for Businesses and Policymakers.” And it’s a preliminary FTC staff report.

Joanne McNabb, Chief, California Office of Privacy Protection, is “chief cajoler” and not a regulator.

Greene spoke about how HIPAA requirements are not really a check list but dependent upon the particular circumstances and business processes. Greene also wanted to disabuse people of the notion that they have 60 days to report a breach event of Protected Health Information (PHI). In fact, they are required to notify HHS of a breach on 500 individuals or more as quickly as possible, no later than 60 days.

FTC does not have specific rules about breach notification, except in case of PHRs, based on HITECH.

McNabb spoke of prohibition of marketing from data in PHRs, and also be careful about using mobile devices to move PHI. California’s Privacy office Web site is

Garrison said we heard alot about trust today and trustworthiness. Per Ponemon report on security, that there was not enough support for healthcare privacy and issues in hospitals. Security is not a check list; it’s an ongoing process according to Garrison. Garrison also expressed concern about location of PHI on the 18 of 20 PHRs that had gone out of business since John Moore had studied them.

Second subpanel section
New group of panelists consists of three lawyers and law professors.

Robert Hudock, JD, Counsel, EpsteinBeckerGreen sees keysecurity issue is integrity. Sees smart phones as more secure than computers. Suggests that we let mobile devices and security evolve, and don’t restrict it while still developing. Hudock’s biggest privacy issue is for the average person being able to protect the confidentiality of  family’s information.

Frank Pasquale, JD, Schering-Plough Professor in Healthcare Regulation and Enforcement, Seton Hall Law School, lauded Markle Foundation’s emphasis on identification of versioning. There are many issues around research. He really worries when data is collected from various sources, and the digital self created from those sources. Pasquale identified several technological solutions and books.

Nicholas Terry, Chester A. Myers Professor of Law, Saint Louis University School of Law, asked what we mean by security. Data scraping is one of the issues of great concern to him. Trust is big at moment, but Terry said he doesn’t know what trust means.

Session ended with brief period with public comments.

Morning Session:
Morning session video
Afternoon Session:
Afternoon session video
*Please note: Apple QuickTime is required to view the video. To download and install QuickTime, visit

For PHR Roundtable information on ONC site, click here.