Congress dishes out HIT budgets, interoperability probes

By Anthony Brino
08:04 AM

Ten years after the creation of the Office of the National Coordinator for Health IT, amid record partisan discord, lawmakers are trying to address problems they see in the direction of health IT’s evolution.

In the “Cromnibus” — the $1 trillion Consolidated and Further Continuing Appropriations Act of 2015 — signed by President Obama, Congress has dispensed some new interoperability requests for the ONC, as well as mandates for the veterans and military health systems.

In a report accompanying the Cromnibus, Congress asked ONC to decertify electronic health records software that “block” data exchange.

ONC “should use its authority to certify only those products that clearly meet current meaningful use program standards and that do not block health information exchange,” the report reads. “ONC should take steps to decertify products that proactively block the sharing of information because those practices frustrate Congressional intent, devalue taxpayer investments in (Certified EHR Technology), and make CEHRT less valuable and more burdensome for eligible hospitals and eligible providers to use.”

Congress asked the ONC to draft a report, by March, outlining the problem of information blocking, with estimates on the number of vendors, eligible hospitals and providers blocking exchange. The ONC’s Health IT Policy Committee has also been asked to report on the technical, operational, financial and policy barriers to interoperability, by the end of 2015.

The Cromnibus itself does not mandate ONC to make any decertifications from its list of EHR systems approved for the Meaningful Use program, although the agency said it will issue the reports.

“We understand the importance of the issues about interoperability of health IT raised by members of Congress, which is one of the reasons we are expecting to issue the draft interoperability roadmap next month,” the ONC said in a statement. “The roadmap will address many of the challenges associated with achieving our long-term interoperability vision, including the need to promote a business and regulatory environment that promotes interoperability and exchange. In addition, we recently announced we are working closely with the Federal Trade Commission to better understand health IT market dynamics and encourage greater competition and innovation to deliver interoperable systems and services.”

The Cromnibus allocated $60 million for ONC’s budget, about $15 million less than the budget proposal requested. Congress also did issue some health information technology mandates, strings attached to the funding as it were, in the area of military health.

The budget law requires the Department of Veterans Affairs and Department of Defense to report on their progress in long-awaited EHR updates.

The VA received about $160 billion in total and $4 billion for IT, including $123 million for enhancements in its VistA electronic health record, while the DoD received $554 billion in total.

The DoD is planning a $11 billion overhaul to its military health EHR — a matter of great interest to lawmakers, after years of stalled progress on interoperability with the VA.

The Cromnibus prohibits the VA from spending more than 25 percent of its allocated IT funds until it reports back to Congress on its plan to achieve interoperability with the DOD's system, Likewise the DoD cannot spend more than 25 percent of its allocations on the Defense Healthcare Management Systems Modernization until it reports back on interoperability and implementation progress.

Elsewhere in the budget, Congress allocated $14.9 million to the Health Resources and Services Administration to help small, rural hospitals with health IT adoption, and gave $10.3 million to the Department of Agriculture to fund rural broadband for telehealth and distance learning. The budget also gave CMS authority to build a platform to collect and share public health data for state public health departments.