There is a critical element in the American Recovery and Reinvestment Act (ARRA) that targets funds for Federally-Qualified Community Health Centers (FQHCs).
An FQHC is an organization defined by the Medicare and Medicaid statutes that receives funding under Section 330 of the Public Health Service Act. FQHCs provide primary care services for all age groups and provide preventive health services on site to some of the country's most vulnerable populations, and they are an important part of this country's primary care delivery system. Among services that FQHCs must provide directly (or by arrangement with another provider) include: dental services, mental health and substance abuse services, transportation services necessary for adequate patient care, hospital and specialty care. There are more than 16 million Americans who are served by FQHCs.
Some of the $1.5 billion in infrastructure funding from the HITECH section of the ARRA may be used for “acquisition of Health Information Technology (HIT) systems” and all FQHCs are eligible for these funds. This funding can be used to support the acquisition of HIT in a number of ways including construction, renovation and required equipment. There will be additional grant funds through the Department of Health and Human Services (HHS) Office of the National Coordinator for Health Information Technology (ONCHIT). FQHC’s would be paid up to 85 percent of “allowable costs” (as determined by HHS) for the acquisition, implementation (including training), upgrade, maintenance, and use of a “certified electronic health record” system (certified by the Certification Commission for Health Information Technology--CCHIT).
But there is a problem: the ARRA funds are terrific if you belong to CCHIT-land, but what if you don’t?
Let me explain. I am a clinician at one of finest HIV/AIDS clinics in the Unites States, located within the San Francisco General Hospital. We are at the epicenter of the AIDS epidemic. I am also the director of our Health Informatics Group. We have an EHR software system developed and refined by the clinicians and our technology leaders (including a personal health record for our patients ) that has provided the backbone for documentation of care, for care coordination and planning, and for our cutting edge research activities since April 2000. We exchange data across many organizations through the use of the CCR standard (connecting with Google Health), as well as HL7 (laboratory values) for our transactions. The AIDS clinic at SFGH is an FQHC and so we are eligible for these federal HIT funds. We would use the funds to replace old and outdated servers, provide additional programming innovations, create new jobs and help with patient education and training. We would hire new software programmers for some cutting edge applications (first up is a program to help victims of intimate partner violence) and new educators to help our patients get on line and work with the team to stay connected out in the community. Thus we believe that the ARRA funds identified for FQHC and HIT should support local solutions that use open standards. We would thrive in this scenario and continue to innovate solutions for our patients and support effectiveness-based research.