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Health IT Office Shifts from Grants to Interoperability

By John Reichard, CQ HealthBeat Editor

June 2, 2014 -- Now a decade old, the Office of the National Coordinator for Health Information Technology is shifting out of the grant-making role it played earlier in the Obama administration to an organizational structure that aims to advance the exchange of data among different types of providers.

The buzzword is "interoperability." It's a dimension some employers, vendors, consumers and lawmakers say the office too long has de-emphasized because of pressure from doctors and hospitals.

"Health IT infrastructure and program investments are ending and it is our responsibility to take this opportunity to reshape our agency to be as efficient and effective as possible," Karen DeSalvo, the national coordinator, said in a message to staff late last week announcing the reorganization.

Health IT provisions in the economic stimulus law (PL 111-5) provided hundreds of millions of dollars in grants to establish regional extension centers, "beacon communities" and health information exchanges. As billions of dollars in bonus payments began flowing through Medicare and Medicaid to help providers pay for technology, the Department of Health and Human Services also awarded the grants to guide how that money was being used.

The extension centers teach providers, particularly rural hospitals and small physician practices, in installing the technology. The beacon grants have gone to help 17 pace-setting communities adopt health IT to further realize its potential. And the grants for health information exchanges also aim to promote the exchange of medical data among various players in local health care systems.

But those funds are only temporary. Interoperability is essential to the success of health IT—it refers to the easy exchange of medical data not just within a health system, but among different parts of the system to avoid duplicative testing and coordinate treatment.

To realize the technology's potential to make care safer and more efficient, experts say data must be shared among clinicians, labs, hospitals, pharmacies, and patients regardless of the application or application vendor.

"This realignment will support our focus on developing and implementing an interoperability road map" and support "care transformation," DeSalvo said. New offices under the reshuffled structure include an Office of Care Transformation headed by Kelly Cronin and an Office of the Chief Scientist headed by Doug Fridsma. Fridsma's office will be responsible for spurring development of more innovative products and systems.

Whether the new structure will satisfy critics of the health IT program remains to be seen, but the nod toward interoperability recognizes their concerns.

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