Program and Policy Memos
Providing patients with opportunities to give feedback rightly acknowledges that patient-generated information can enhance the accuracy and completeness of the medical record. This report demonstrates that patients can be effectively engaged online to improve the quality of the information stored in their EHRs.
This new report from the Urban Institute explores the story behind the dramatic increase in electronic health record (EHR) adoption numbers, with the aim of identifying lessons from the experiences of early adopters. The new white paper summarizes the findings of 75 articles identifying best and promising practices for implementing and optimizing electronic health records. The findings highlight the importance of engaging staff at all levels early and throughout the process of EHR adoption, allowing quality improvement goals to drive health IT utilization, investing resources in workflow redesign and training, and fostering and leveraging the enthusiasm of champions such as clinical leaders and super-users.
The purpose of this document is to provide an intuitive summary of the history and current state of standards and specifications for clinical document exchange in healthcare. This paper also addresses the implications that new Stage 2 Meaningful Use (MU) standards will have on prior work efforts, and in particular, the work of Beacon Communities.
Federal efforts toward ensuring that all Americans benefit from electronic health record (EHR) technology were expanded and supported through the American Recovery and Reinvestment Act of 2009 (ARRA) funds. These statistics and program highlights offer insight into the adoption and use of health IT and showcase federal programs that are working to continue this forward momentum.
As part of its mission, ONC aims to coordinate the adoption and use of health IT to support broader objectives of integrating behavioral health and primary care. This roundtable was an important first step in developing a behavioral health IT strategy in support of this mission. ONC worked with participants during the roundtable to identify priority areas for using health IT to achieve better integration, and to discuss options for addressing these areas.
Based on empirical evidence and the research literature on consumer eHealth, a workgroup of ONC’s expert panel on Unintended Consequences of Health IT and Health Information Exchange has categorized potential unintended consequences associated with consumer eHealth and offered “strategies for success” and “questions for further research” to advance consumer eHealth. The resulting report summarizes the literature on the substantial benefits of consumer eHealth as context for understanding the inevitable, even if not always expected, challenges that arise with potentially powerful new health IT targeted at empowering and engaging patients and their caregivers. This report is recommended to everyone committed to building better consumer eHealth.
This white paper was commissioned by ONC to provide input to our thinking and to improve stakeholder understanding and awareness about the potential unintended consequences of HIE. Based on empirical evidence, a health information exchange literature review, and their own experience, an expert panel as part of ONC’s Unintended Consequences of Health IT contract identified seven categories of potential unintended consequences associated with health information exchange and suggested mitigating strategies to strengthen health information exchange. ONC will consider the expertise captured in the report and will evaluate any recommended next steps in light of existing efforts and budget.
This report summarizes key findings from the Long-Term and Post-Acute Care (LTPAC) roundtable discussion and outlines options based on the discussion for ONC’s Federal Advisory Committees members—the HIT Policy and HIT Standards Committees—to consider when developing recommendations for additional EHR Certification Criteria (EHR CC) and additional Stage 3 MU requirements and measures.
On February 1, 2012, the White House Office of the National Coordinator for Health Information Technology and the White House Office of Science and Technology Policy hosted a group of leading game designers, researchers, and government officials to explore the potential for games to improve health and health care. That discussion focused on three areas:
- Understanding the current landscape of games and health;
- Identifying areas where game dynamics and health needs could intersect to improve health outcomes in the future;
- Identifying areas where the federal government could play a role in promoting innovations in health games.
This report summarizes the key discussion points from the day.
These summaries support the global assessment by synthesizing in one place on selected statistics and activity reports relating to implementation of HITECH. It is developed quarterly and reflects information made available from January 2011 onwards. The list of activities included in these reports are not meant to be exhaustive but to reflect a subset of reports and activities captured by reports on the ONC or CMS web site.
- Q3 2014 (July-September 2014) [PDF - 362 KB]
- Q2 2014 (April-June 2014) [PDF - 290 KB]
- Q1 2014 (January-March 2014) [PDF - 357 KB]
- Q4 2013 (October-December 2013) [PDF - 283 KB]
- Q3 2013 (July-September 2013) [PDF - 347 KB]
- Q2 2013 (April-June 2013) [PDF - 287 KB]
- Q1 2013 (January-March 2013) [PDF - 767 KB]
- Q4 2012 (October-December 2012) [PDF - 390 KB]
- Q3 2012 (July-September 2012) [PDF - 392 KB]
- Q2 2012 (April-June 2012) [PDF - 337 KB]
- Q1 2012 (January-March 2012) [PDF - 521 KB]
- Q4 2011 (October-December 2011) [PDF - 350 KB]
- Q3 2011 (July-September 2011) [PDF - 333 KB]
- Q2 2011 (April-June 2011) [PDF - 258 KB]
- Q1 2011 (January-March 2011) [PDF - 454 KB]
The State HIE Cooperative Agreement Program funds states’ efforts to rapidly build capacity for exchanging health information across the health care system both within and across states. Awardees are responsible for increasing connectivity and enabling patient-centric information flow to improve the quality and efficiency of care. ONC funded NORC at the University of Chicago to conduct a multi-year program evaluation. These research reports and case studies focus on understanding the implementation of the program and emerging approaches for enabling HIE.
- Case Study Report: The State HIE Program Four Years Later: Key Findings on Grantees’ Experiences from a Six-State Review [PDF - 835 KB] - December 2014
- Key Challenges to Enabling Health Information Exchange and How States Can Help [PDF – 442 kb] – August 2014
- State Approaches to Enabling HIE: Typology Brief [PDF – 4 MB] – August 2014
- Case Study Synthesis [PDF - 875 KB] - February 2013
- Case Study Report: Health Information Exchange (HIE) in Maine [PDF - 375 KB] - November 2012
- Case Study Report: Experiences from Nebraska in Enabling Health Information Exchange (HIE) [PDF - 400 KB] - November 2012
- Case Study Report: Experiences from Texas in Enabling Health Information Exchange (HIE) [PDF - 350 KB] - November 2012
- Case Study Report: Experiences from Washington State in Enabling Health Information Exchange (HIE) [PDF - 360 KB] - November 2012
- Case Study Report: Experiences from Wisconsin in Enabling Health Information Exchange (HIE) [PDF - 355 KB] - November 2012
- Provider Focus Group Brief [PDF - 765 KB] - February 2012
- Early Findings from a Review of Twenty-Seven States [PDF - 303 KB] - January 2012
- The Evolution of the State HIE Cooperative Agreement Program: State Plans to Enable Robust Health Information Exchange [PDF - 452 KB] - August 2011
- Improving Transitions of Care in LTPAC: An Update from the Theme 2 Challenge Grant Awardees [PDF - 1.7 MB] - March 2013
In February, 2011, ONC awarded ten Challenge Grants intended to encourage breakthrough innovations for HIE that can be leveraged widely to support nationwide health information exchange and interoperability. Four of those awards went to Colorado, Maryland, Massachusetts, and Oklahoma to develop solution and best practices to improve long-term and post-acute care (LTPAC) transitions. This mid-point check-in identifies the common strategies and approaches the grantees have leverage to improve transitions of care to and from LTPAC providers including: common processes and appropriate connection points for clinical information transfer between hospitals and LTPAC providers; recommendations for hospital and LTPAC provider data needs; strategies to promote the use of standards based technology to create, transmit and view clinical documents of relevance to LTPAC and approaches to engage LTPAC providers where they are today across the health IT adoption spectrum (from high adoption to no adoption).
This collection of case studies highlights nine community-based programs using health IT to address the needs of populations with documented disparities in access, quality of care, and outcomes. Each case study discusses the type of intervention used and the providers and populations involved, providing detail on stakeholders' experience adopting and using various health IT solutions to improve health care delivery and outcomes for vulnerable groups.
- Understanding the Impact of Health IT on Underserved Communities and those with Health Disparities [PDF - 954 KB]* - April 2012
*These reports were completed by NORC at the University of Chicago under contract to ONC. The findings and conclusions of this report are those of the authors and do not necessarily represent the views of ONC or the U.S. Department of Health and Human Services.
- Using telepsychiatry for the treatment of depression in underserved Hispanics [PDF - 754 KB] - July 2012
- Enabling service: Using health IT to ensure patients receive more than just health care [PDF - 749 KB] - July 2012
- Promoting and tracking wellness behaviors within an existing case-management program [PDF - 682 KB] - July 2012
- Using health IT to improve quality, coordination, and access for rural and migrant populations [PDF - 726 KB] - July 2012
- Leveraging health IT to provide quality care [PDF - 637 KB] - July 2012
- PHRs: Connecting at-risk youth to health and social services [PDF - 637 KB] - July 2012
- Using multi-modal health IT tools to improve quality and delivery of care in an urban setting [PDF - 650 KB] - July 2012
- Using telehealth to improve chronic disease management [PDF - 678 KB] - July 2012
- GAHITREC: Helping eligible providers reach Meaningful Use [PDF - 696 KB] - July 2012
- Health Information Technology Infrastructure to Support Accountable Care Arrangements [PDF - 697 KB]
The new report takes a look at what some communities have been doing to leverage health IT to support value-based payment initiatives. It also looks at how stakeholders in Bangor, Maine and Austin, Texas have made significant IT investments to support providers making the transition away from the current fee-for-service delivery system.
A working paper entitled “How Early Adopting Hospital Systems View the Business Case for Health Information Exchange” by Mathematica as part of the Global Evaluation of HITECH has been posted. This study involved structured telephone interviews with senior executives responsible for health information exchange in selected large hospital-based systems. Although the study was small, its findings are consistent with prior research on the means and barriers to electronic health exchange. The study also documents the growing sense—at least among some large provider systems—that electronic information exchange is perceived as a valued asset.
Focuses on Stage 1 MU readiness in four diverse regions—Seattle, WA, Lubbock, TX, New Haven, CT, and Topeka, KS— as of late 2012.
Focuses on Stage 2 MU readiness in four regions with relatively high EHR adoption rates—Worcester, MA, Macon, GA, Milwaukee, WI, and Sacramento, CA— as of late 2013.
These issue briefs explore how local context affects HITECH program implementation as well as providers’ incentives and ability to achieve Meaningful Use (MU). These briefs identify the influence that state governments and policies, local grantees charged with implementing particular HITECH programs, health care market and community characteristics, and current health care reform efforts are having on providers’ incentives and ability to meaningfully use EHRs and qualify for Medicare and Medicaid incentive payments.
- Final Report of Assessing the SHARP Experience [PDF - 810 KB] - July 2014
- Final Report Appendices of Assessing the SHARP Experience [PDF - 1.86 MB] - July 2014
The goal of ONC’s SHARP program was to support innovative research in several challenging issues of health IT. ONC funded an independent evaluation of the program that conducted structured interviews with the four SHARP grantees, ONC program officers, and other stakeholders throughout the performance period of the grant. This report provides the summative findings of the evaluation. It includes details on the structure and objectives for each of the four SHARP grantees. In particular, it highlights the successes, challenges, and lessons learned from this project.
This report is part of the independent national evaluation of the Regional Extension Center (REC) program. The nine case studies summarized in this report explored the experiences of REC grantees in implementing the program as well as the challenges faced by providers as they adopt and meaningfully use EHRs. Findings of the report are organized around how RECs structured and organized their programs, strategies RECs used to recruit eligible providers, the range of services offered by RECs, challenges associated with assisting providers adopt and meaningfully use EHRs, and strategies for overcoming these challenges. The three salient strategies for helping providers achieve MU are forging strategic partnerships, using technical assistance staff with clinical and IT skills, and using a champion to engage providers and sustain interest in achieving meaningful use of health IT.
- Vision for the Strategic Health IT Advanced Research Projects (SHARP) Program [PDF - 269 KB] - March 2012
This paper presents the motivation and objectives of ONC's SHARP program both at its inception and in the current context of health care in the United States. It offers a brief review of the history and mechanics of the program, including the research areas targeted by program funding. In addition, it describes the anticipated outputs and benefits from SHARP and reviews the approaches to program management, results dissemination, and collaboration that can help extend and accelerate outcomes of the program.
A multi-year evaluation was conducted to assess the effectiveness of ONC's Workforce Development Program. This report provides an overview of the Workforce Development Program, describes the implementation status through June 2011, and discusses some early programmatic challenges.
- A Report to Congress: Update on the adoption of health IT and related efforts to facilitate the electronic use and exchange of health information [PDF - 1.44 MB] - October 2014
This 2014 Report to Congress describes the specific actions that have been taken by the federal government and private entities to facilitate the adoption of a nationwide system for the electronic use and exchange of health information; describes barriers to the adoption of such a nationwide system; and describes efforts to gather and use recommendations to achieve full implementation of such a nationwide system.
Previous Submissions can be found below:
This Report to Congress discusses initiatives and incentives for improving health care quality in federally qualified health centers, rural health clinics, and free clinics. It also provides an overview of the current knowledge regarding quality of care and the use of health IT in these facilities.
- A Report to Congress: Quality Incentives for Federally Qualified Health Centers, Rural Health Clinics and Free Clinics [PDF - 1.3 MB] - January 2012
- Overcoming Challenges to Health IT Adoption in Small, Rural Hospitals [PDF - 2.62 MB] - October 2011
The Office of the National Coordinator for Health Information Technology (ONC) funded the Altarum Institute to examine challenges to health IT adoption in small, rural hospitals. This report provides summarizes specific health IT adoption challenges faced by small, rural hospitals and discusses key management strategies they can employ to address the challenges. Findings in this study draw upon information from site visits and interviews with key staff at eight small, rural hospitals throughout the United States, selected from a range of levels of EHR adoption, financial health, and patient and payer mix.
This white paper reviews key components of the Centers for Medicare and Medicaid Services (CMS) Electronic Health Record (EHR) Incentive Program specific to the circumstances and need of Critical Access Hospitals.
ONC's Workforce Development Program's primary goal is to train a new workforce of health IT professionals who will be ready to help providers implement and maintain electronic health records to improve health-care quality, safety, and cost-efficiency. In support of the Workforce Development Program, ONC funded NORC at the University of Chicago (NORC) to perform an independent program evaluation. These research briefs and reports describe the grantees' implementation efforts using data from surveys, focus groups, and interviews with students and other key stakeholders involved with the program. The briefs and reports explore the funded colleges’ approaches to integrating evolving and newly developed curricula, recruiting and training faculty and prospective students, and coordinating among the four grant programs. Additionally, these briefs synthesize key programmatic themes, and identify program challenges and successes to date.
- Final Report from the Evaluation of the Workforce Development Programs [PDF - 8 MB] - March 2014
- Final Report from the Evaluation of the Workforce Development Programs: Executive Summary [PDF - 376 KB] - March 2014
- Findings from NORC’s University-Based Training Site Visits [PDF - 595 KB] - March 2013
- Findings from NORC’s Community College Site Visits [PDF - 630 KB] - January 2013
- Implementation of ONCs Workforce Development Program [PDF - 561 KB] - August 2012
- Overview of ONC's Workforce Development Program [PDF - 254 KB] - June 2011