AMIA, Pew Urge Congress to Ensure ONC has Funding to Implement Cures Provisions

Dec. 15, 2017
The Pew Charitable Trusts and the American Medical Informatics Association (AMIA) have sent a letter to congressional appropriators urging them to ensure that ONC has adequate funding to implement certain 21st Century Cures Act provisions.

The Pew Charitable Trusts and the American Medical Informatics Association (AMIA) have sent a letter to congressional appropriators urging them to ensure that the Office of the National Coordinator for Health IT (ONC) has adequate funding to implement certain 21st Century Cures Act provisions.

In the letter, the organizations noted that a senior ONC official recently stated that the federal health IT agency would be unable to fully implement bipartisan provisions from the 21st Century Cures Act (Cures) if the President’s budget request is enacted. Indeed, President Trump’s budget proposal for 2018, which was unveiled to the public this past spring, included a $22 million cut to ONC—from $60 million down to the proposed $38 million. The $60 million figure for ONC has held steady for the past few years under the Obama Administration.

Since that time, industry organizations such as Pew, have urged lawmakers to ensure that ONC has proper funding. Also, Congresswoman Jacky Rosen, a member of the House of Representatives from Nevada, introduced a brief amendment to the federal government’s spending bill that would restore that planned $22 million cut. Nevertheless, the House-passed appropriations legislation for ONC would enact this cut; meanwhile the bill under consideration in the Senate would maintain current funding levels.

As stated in the bipartisan Cures legislation, Congress established an EHR (electronic health record) reporting program, wherein the developers of these systems would submit data on the functions of their products. “Through this program,  hospitals,  clinicians  and  other  users  of  health IT have greater transparency on how these products perform, including their ability to exchange data with other  systems—known  as  interoperability—and  usability—which  refers  to the layout of the systems and how they’re used,” the letter read.

What’s more, the organizations noted that the EHR reporting program is also an important component of another provision from Cures that establishes new conditions of certification for EHRs. “To meet these new conditions of certifications, EHRs must address a series of criteria, including not restricting communication on their product’s performance, attesting to real-world testing, and submitting data related to the EHR reporting program. As a result, the conditions of certification established in Cures can also not be met until the reporting program is established. Through the reporting program—along with other conditions of certification—EHR developers and healthcare providers will have better information on which to improve and inform the development, purchasing, implementation and customization of products,” the letter read.

The issue at hand, the letter outlined, is that while Congress originally authorized $15 million through Cures for federal health officials to implement this EHR reporting provision, Jon White, M.D., ONC Deputy National Coordinator for Health IT, recently stated, “Under  the  current budget  proposal,  we  are  expecting  to  meet  all  the  requirements  of  the  Cures Act  with  the exception of the EHR reporting program.”

But Pew and AMIA stressed the importance of the program coupled with its inclusion as part of the new conditions of certification. They concluded, “Since  EHRs  are  foundational  to  many  other  goals  of  the  Cures  Act,  the timely  development  and  implementation  of  these  programs  is  paramount. We urge  you  to  ensure  that  the  agency  has  the  resources  it needs  to establish the program and—when  doing  so—prioritize  policies  that  enhance  patient safety and care coordination.”

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