Several blog readers have asked me to take a fresh look at all the organizations related to ARRA and explain how it all works. Here's my understanding:

Office of the National Coordinator
The Obama administration's ONC is different from the Bush administration's ONC in several ways. It's now funded with $2 billion to accelerate healthcare IT adoption. Its new leader, Dr. David Blumenthal has a policy focus, so we'll see broad policy guidance and specific healthcare outcome goals rather than technology for technology's sake. It has regulation - ARRA is law and there are several new privacy, standards, and implementation requirements that were only voluntary or market-driven previously. You can expect that ONC will have a major role in coordinating federal agencies' use of healthcare IT as well as adoption in the private sector. By controlling the definition of meaningful use of healthcare IT as the gatekeeping function for paying stimulus dollars to clinicians, ONC has real power.

HIT Standards Committee
The Health IT Standards Committee is charged with making recommendations to the National Coordinator on standards, implementation specifications, and certification criteria for the electronic exchange and use of health information. Initially, the HIT Standards Committee will focus on the policies developed by the Health IT Policy Committee’s initial eight areas (listed below). The HIT Standards Committee will also provide for the testing of standards by the National Institute for Standards and Technology (NIST). In its first meeting, the HIT Standards Committee created three workgroups. Below are their Broad and Specific charges:

Clinical Operations Workgroup:
Broad Charge –
Make recommendations to the HIT Standards Committee on requirements for standards, implementation specifications, and certification criteria related to EHRs and clinical operations.

Specific Charge –
Make recommendations to the HIT Standards Committee on the role of EHRs and e-prescribing, clinical summaries, laboratory and radiology report functionality within two (2) months of the workgroup’s first meeting. The workgroup will also take into consideration the eight (8) areas listed in Section 3002(b)(2)(B) when developing recommendations for the committee.

Clinical Quality Workgroup:
Broad Charge –
Make recommendations to the HIT Standards Committee on quality measures that should be included in the Meaningful Use definition and for future EHR requirements. Make recommendations to the HIT Standards Committee on requirements for standards, implementation specifications, and certification related to EHRs and clinical quality.

Specific Charge –
Make recommendations to the HIT Standards Committee on specific quality measures that should be included in the definition of Meaningful Use for 2011 within two (2) months of the workgroup’s first meeting. The workgroup will also take into consideration the eight (8) areas listed in Section 3002(b)(2)(B) when developing recommendations for the committee.

Privacy and Security Workgroup:
Broad Charge –
Make recommendations to the HIT Standards Committee on privacy and security requirements for standards, implementation specifications, and certification criteria.

Specific Charge –
Make recommendations to the HIT Standards Committee on specific privacy and security safeguards that should be included in the definition of Meaningful Use, with a specific focus on the eight (8) areas listed in Section 3002(b)(2)(B), within two (2) months of the workgroup’s first meeting.

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