The Pew Charitable Trusts’ manager of health IT has written a letter to lawmakers urging them to ensure that the Department of Health and Human Services (HHS)’ 2018 funding not be cut as outlined in President Trump’s recent budget proposal.
The president’s proposed budget for 2018, unveiled to the public on May 23, included significant cuts to various departments that touch health IT, including the Office of the National Coordinator for Health IT (ONC), the health IT branch of the government within HHS. In Trump’s request, ONC would have its $60 million budget slashed to $38 million. The $60 million figure for ONC has held steady for the last few years under the Obama Administration. In the budget request, ONC’s staff would also be in line to lose 26 members of its staff next year, from 188 down to 162. The staff increased by 14 from 2016 to 2017.
This caused Pew’s health IT manager, Ben Moscovitch, to write to four lawmakers on congressional health subcommittees, “As you consider the President’s fiscal year 2018 budget request for the Department of Health and Human Services we urge you to ensure that the agency has sufficient resources to advance these goals. Additionally, the agency should prioritize policies to improve electronic health record (EHR) usability, which refers to the layout of EHRs and how clinicians use them, as poor usability can cause safety risks for patients.”
The letter noted that as part of the 21st Century Cures Act, Congress instructed ONC to implement several new policies—including the development of a program wherein EHR developers submit data on various functions, such as on interoperability and usability. “The success of these congressional priorities relies on the agency having adequate resources and prioritizing efforts to enhance patient safety and care quality,” the letter said, further noting that the 114th Congress authorized an additional $15 million for ONC to implement the new program for EHR developers to submit data on their products.
It continued, “The President’s proposed budget would cut ONC’s budget by $22 million, or by more than a third, even though the agency must both maintain many existing programs and implement new authorizations. The President’s budget includes these cuts despite outlining many of the same priorities as Congress—specifically advancing usability and interoperability.” It should be noted that reports have attested that Congress is expected to reject many of the proposals as it takes up the budget in the coming weeks and months.
Moscovitch outlined a specific example of where a cut in finding could have a major impact. He said that as part of the reporting program authorized through the Cures Act, Congress has required ONC to develop a series of measures to evaluate the interoperability and usability of EHRs. He wrote, “One key aspect of usability is patient safety; if the technology is not easy to use or intuitive, then clinicians may inadvertently prescribe the incorrect dose of a medication, miss critical information, or order a test on the wrong patient. When implementing usability-related measures as part of this reporting program, itis critical that ONC ensure that some of the criteria focus on safety.”
Other industry groups have expressed similar sentiments regarding what effect budget cuts of this size could have on healthcare and health IT. However, there are also those who believe that ONC’s responsibilities need to be cut back, particularly related to the level of oversight the agency has on the marketplace.
