On Aug.12, the Department of Health and Human Services (HHS) announced a new program that will be providing grants to support the building of public health reporting infrastructure through health information exchanges (HIEs), as administered by the Office of the National Coordinator for Health IT (ONC).
On Wednesday, a description of the program, entitled “Strengthening the Technical Advancement and Readiness of Public Health via Health Information Exchange Program,” or the “STAR HIE Program” for short, was posted to the ONC website, with a notice of September 1 as the application due date, and September 30 as the anticipated award date.
A press release made public on Wednesday morning noted that “HHS today issued a Notice of Funding Opportunity to expand and accelerate innovative uses of electronic health information via HIEs to support state and local public health agencies. Strengthening health data exchange and use between HIEs and state and local public health agencies will help communities to better prevent, respond to, and recover from public health emergencies, including disasters and pandemics such as COVID-19. With $2.5 million in funding from the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) signed by President Trump on March 27, 2020, the HHS Office of the National Coordinator for Health Information Technology will award up to five (5) cooperative agreements under the Strengthening the Technical Advancement and Readiness of Public Health Agencies via Health Information Exchange (STAR HIE) Program,” the press release noted.
And it went on to state that “Award recipients will focus on improving HIE services (such as last-mile connectivity and data services) in support of state and local public health agencies. The STAR HIE Program aims to strengthen existing state and local HIE infrastructure so that public health agencies are able to better access, share, and use health information as well as support communities that have been disproportionately impacted by the COVID-19 pandemic.”
The press release quoted Don Rucker, M.D., National Coordinator for Health Information Technology, as stating that “State and local HIEs play a unique role in their communities by uniting health information from many different sites of service, including providers, hospitals, nursing homes, clinical laboratories, and public health departments, making them a natural fit to deliver innovative, local ‘last mile’ approaches to strengthen our overall public health response. The funding opportunity we announced today,” Dr. Rucker said, “will invest in infrastructure and data services for HIEs that provide critical real-time information to communities at the frontlines of responding to the COVID-19 pandemic.”
It added that “Award recipients will be required to deploy services that can enable, enhance, or increase the use of health information exchange at the state and local levels among relevant entities, and be inclusive of a diverse set of participating providers, including those who care for vulnerable or at-risk populations. They also will be required to engage in activities that address communities disproportionately impacted by the COVID-19 pandemic, considering factors such as age, race, ethnicity, disability, and sex.”
According to the HHS/ONC announcement on the ONC website, “Awardees in the STAR HIE Program (Program) will build upon previous and existing federal investments in health information exchanges (HIEs) and will leverage work done by the industry to advance HIE services for the benefit of public health. The result of these efforts would be improved linkages between public health agencies and the services that HIEs are well situated to provide. These services include, but are not limited to, establishing or updating:
> Services that benefit public health registries;
> Connectivity services that benefit a public health agency; and/or
> Data services that benefit a public health agency.
This Program seeks to respond to the needs facing public health agencies by leveraging the unique abilities and characteristics of HIEs. These include, for example, the following:
> HIEs serve as hubs for rich data from a multitude of sources.
> HIEs are often state, local, or regional entities, with a strong understanding of and experience with local health care environments, including policies dictating data use for public health agencies.
> HIEs facilitate competition within the health care system by acting as trusted third parties who work with otherwise competitive health care entities.
> HIEs either actively support public health agencies or have the ability to do so (e.g., activities such as supporting public health reporting, improving data quality, and other data services).
Currently, there are approximately 100 HIE organizations in the United States,” the announcement noted. “HIEs cover about 99 percent of the Unites States population, according to the national trade association of HIEs.”
ONC noted that “The Program has the following objectives:
1. Build innovative HIE services that benefit public health agencies.
Applicants must propose activities that would benefit public health agencies. This requirement is included in the NOFO because of the unique opportunity that HIEs present with regard to supporting public health agencies. The outcome of achieving this objective will be that public health agencies are more capable of responding to public health events, including pandemics such as COVID-19.
2. Improve the HIE services available to support communities disproportionately impacted by the COVID-19 pandemic.
Applicants must describe how they would deploy services or functionalities to enable, enhance, or increase the use of health information exchange among relevant entities, including providers who care for vulnerable or at-risk populations. Applicants must describe how their activities under the cooperative agreement address communities disproportionately impacted by the COVID-19 pandemic, including as it relates to the stratifying factors of age, race, ethnicity, disability, and sex. The outcome of achieving this objective will be to increase public health understanding of how COVID-19 has disproportionately impacted various communities and increase the capability of public health agencies and the health care system to respond to that impact.
The STAR HIE NOFO is limited competition. It is limited to United States-based HIE entities. The award will allocate $2,500,000 to fund up to five (5) awards with a period of performance of up to two (2) years in the form of cooperative agreements with funding contingent upon availability of funds, satisfactory completion of milestones, and a determination that continued funding is in the best interest of the federal government and the public. ONC plans to award these five awards in the amount of up to $500,000 each.”
According to the full Notice of Funding Opportunity, or “NOFO,” available here, “This Notice of Funding Opportunity (NOFO) is designed to strengthen and accelerate innovative uses of health information via health information exchanges (HIEs) within states, communities, and regions to support public health agencies’ abilities to advance data-driven prevention of, response to, and recovery from public health events, including disasters and pandemics such as Coronavirus Disease 2019 (COVID-19). Funding will be focused toward strengthening existing HIE infrastructure so that public health agencies are able to better access, share, and use health information. This competitive NOFO is limited to only United States-based health information exchange (HIE) entities. This includes non-profit HIEs or for-profit HIEs. However, under 45 C.F.R. 75.216(b), no HHS funds may be paid as profit to any recipient even if the recipient is a commercial organization. The Office of the National Coordinator for Health Information Technology (ONC) anticipates that up to five (5) awards will be made in the form of cooperative agreements. The number of awards could change based on additional availability of funds. The cooperative agreement will focus on improving HIE services in support of public health. The total funding available under this NOFO is $2,500,000.”
The NOFO further noted that “Applications will be approved for up to a two-year (2) period of performance. Entities may enter into multi-organizational and/or regional agreements to apply to this NOFO. However, one singular entity must be the applicant; act as the responsible agent; submit the application on behalf of all partners, who must provide written documentation affirming the applicant’s role as their agent; and maintain accountability for the proper use of federal funds. ONC hopes to distribute funding throughout the country. ONC does not intend to award duplicative service areas.”