Monday, December 28, 2009

ONC 2010 Budget

The Office of the National Coordinator for Health Information Technology (ONC), in the Office ofthe Secretary for the U.S. Department of Health and Human Services (HHS), is the principal Federal organization charged with coordinating national efforts related to the implementation and use of electronic health information exchange. By encouraging providers to adopt health information technology (health IT), both the quality of care and the efficiency with which it is delivered can be improved. Health IT use and adoption is the effective integration of health information products and services that support safer, better health and care. A key ONC role iscoordinating the public and private-sector efforts to improve the quality of health and care through information technology.

A Nation in which the health and well-being of individuals and communities are enabled by health information technology.

ONC leads, coordinates, and stimulates public and private sector activities that promote the development, adoption, and use of health information technologies to achieve a healthier Nation.

ONC provides leadership, program resources and services needed to guide nationwide implementation of interoperable health IT. ONC organizes its activities in four program areas:

• Standards – Standards in health IT-related systems, State-level business policies, and across Federal agencies are important components for achieving nationwide adoption of interoperable health IT. Implementation of common standards allows software applications to work together. Certifying health IT products that incorporate these standards gives assurance that products will be able to work together. Consistent business policies and practices for health information exchange organizations will enable interoperability andsustainability. Coordinating Federal efforts optimizes resources and increases information exchange among Federal and private health care systems.

• Privacy and Security – Careful attention to privacy and security policies to guide evolving technologies will help to build the high degree of public confidence and trust needed to achieve adoption and use of health IT. In addition to developing a privacy and security framework, continuing work identifies disparate State policies and business practices that impede electronic health information exchange across jurisdictional lines.

• Architecture and Adoption – The Nationwide Health Information Network (NHIN) is building on a set of technical and data exchange standards and specifications, and data use and reciprocal support agreements. The NHIN also provides the foundation for population health information exchange, which is important to all aspects of public health. Substantiating the value of electronic and personal health record systems and identifying enablers and barriers to their use and implementation will advance adoption of health IT. Regularly assessing the adoption rate through surveys and studies will monitor progress toward ONC’s goals.

• Operations – Support for administrative, financial and reporting requirements for ONC including planning, procurement, and performance measurement activities.


The American Reinvestment and Recovery Act (Recovery Act) was signed into law by President Obama on February 17, 2009. It is an unprecedented effort to jumpstart our economy, create or save millions of jobs, and put a down payment on addressing long-neglected challenges so our country can thrive in the 21st century. The Act is an extraordinary response to a crisis unlike any other since the Great Depression, and includes measures to modernize our Nation's infrastructure, enhance energy independence, expand educational opportunities, preserve and improve affordable health care, provide tax relief, and protect those in greatest need.

The Office of the National Coordinator for Health Information Technology has received $2 billion in total of Recovery Act funding. As part of this total, the National Institute of Standards and Technology (NIST), Regional Extension Centers and Department efforts to address privacy and security will receive funding in FY 2009. Funding for additional programs in FY 2009 will be determined with the arrival of the new National Coordinator for Health Information Technology.

The Recovery Act instructed the Secretary to transfer $20 million to NIST. These funds will support coordinated efforts between NIST and ONC to advance health care information enterprise integration. Work will focus in areas such as conducting technical standards analysis and establishing a conformance testing infrastructure for electronic health record products. The coordination of this work will increase the adoption rate and use of health IT by making available tested and recognized standards and an infrastructure that will allow vendors to test their products for interoperability prior to going to market.

ONC is developing a program that will support local and regional efforts toward health information exchange. A draft plan to establish Health IT Regional Extension Centers will be published on May 18, 2009. These centers will provide health information technology assistance and services and increase the level of adoption by providing a resource for new users of health IT that will help them with implementing and maintaining their systems.

In addition, a robust program addressing the Privacy and Security concerns related to adoption and use of health IT was initiated in FY 2009. This program will coordinate activities with the HHS Office of Civil Rights, the Centers for Medicare and Medicaid Services and the Substance Abuse and Mental Health Services Administration. These organizations will work together topromulgate regulations and guidance, enhance enforcement of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules, carry out mandated audits and train States Attorney Generals in enforcing the modified regulations. More information on these and other Recovery Act programs can be found at

FY 2010 Budget Overview

The FY 2010 President’s Budget for ONC is $61,342,000 including $19,011,000 in Public Health Evaluation Funds to maintain current service levels. It is an increase of $111,000 above an FY 2009 Omnibus level. This budget supports the implementation of the ONC-Coordinated Federal Health IT Strategic Plan and planned revision, and the HHS Strategic Plan, Goal 1.3:improve health care quality, safety, cost and value.

Program Increases:

  • Operations (+$6,122,000). This increase will provide for infrastructure support and additional term and permanentstaff to fulfill the requirements of the Recovery Act.

  • Architecture and Adoption (+$1,439,000). The Recovery Act provides funding for projects such as the Nationwide Health Information Network (NHIN). The FY 2010 request ($23,250,000) will support development of additional performance measures, work needed to identify the best way to structure consumer-directed access to electronic medical data in a health information exchange, the Health Information Technology Policy Committee and policy-related work that will inform and encourage adoption of health IT.

Program Decreases:

  • Standards (-$5,500,000) The Recovery Act provides funding for projects such as certification and standards harmonization. The FY 2010 requested level of funding ($8,500,000) will support these efforts, provide support for the Health Information Technology Standards Committee,and establish and implement the required NHIN Governance activities.

Office of the National Coordinator for Health Information Technology (ONC) FY 2010 Online Performance Appendix: