Program Brief
To date, the Agency for Healthcare Research and Quality (AHRQ) has awarded more than $166 million in grants and contracts to support and to stimulate investment in health Information Technology (IT). AHRQ has a central role in the movement to adopt health IT.
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Contents
Introduction
AHRQ's Health IT Portfolio
Testing in the Real World
More Information
Introduction
Over the past 35 years, AHRQ and
its predecessor agencies have made
development of informatics
an agency priority. In addition,
AHRQ-supported research has played a
central role in identifying the need for
improvements where health IT was
applicable. As the Nation's lead research
agency on the quality, safety, efficiency,
and effectiveness of health care in
America, AHRQ has a central role in
the movement to adopt health IT.
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AHRQ's Health IT Portfolio
AHRQ's health IT initiative targets
communities and regions as they plan
and implement health IT projects. The
initiative awarded its first grants and
contracts in October 2004, and to date,
includes more than $166 million in
grants and contracts in 41 States to
support and stimulate investment in
health IT.
An important feature of our
approach is that we use knowledge
transfer from early adopters to new
adopters, technical assistance to those
we fund, and a research and evaluation
component that identifies technologies
and strategies that work, so that each
iteration does not repeat mistakes but
builds on learning. Through these and
other projects, AHRQ and its partners
will identify challenges to health IT
adoption and use, solutions and best
practices for making health IT work,
and tools that will help hospitals and
clinicians incorporate new IT
successfully.
The following comprise
AHRQ's current HIT portfolio:
State and Regional
Demonstrations (2004-2010). Six
States (CO, DE, IN, RI, TN, and
UT) have been awarded 5-year
contracts of $1 million a year each
over 5 years to identify and support
State and regional data sharing and
interoperability activities and to
demonstrate measurable
improvements in care resulting from
clinical data exchange.
The demonstrations allow access to
patient information at the point of
care, connect systems of various local
health care providers for better care
coordination, and allow public and
private health care providers to share
patient data. The six States are
developing a variety of approaches
with different technical, business,
and governance models.
HIT Grants (2004-2007). AHRQ
has awarded over 100, 3-year grants
for planning, implementation, and
testing the value of health IT
investment set in the context of
quality improvement or patient
safety. Also included are smaller
investments that test the clinical
impact of specific instances of health
IT implementation.
National Resource Center for
Health IT (2004-2009). This 5-year
contract:
- Provides technical assistance
and resource support to AHRQ and
HRSA grantees and contractors.
- Develops models and tools.
- Maintains knowledge library
and produces case studies and other materials to
capture lessons learned.
- Hosts national teleconferences
on current issues in HIT adoption.
Privacy and Security Solutions for
Interoperable Health Information
Exchange (HIE) (2005-2007). In
2005, AHRQ awarded a contract to
RTI International in a national effort
to address privacy and security policy
questions with HIEs. Under the
contract, RTI has subcontracted
with 33 States and Puerto Rico to
assist them with doing the following:
- Identifying variations in organization-level business privacy and
security policies and practices
that affect electronic HIE.
- For those practices that States
consider desirable, documenting
and incorporating them into
proposed solutions; and for those
with a negative impact, identifying
the source(s) of the policy or
practice and proposing alternatives
to meet the same need.
- Incorporating State and community
interests, and promoting
stakeholder identification of
practical solutions and implementation
strategies through an
open and transparent consensus-building
process.
- Leaving behind in States and
communities a knowledge base
about privacy and security issues
in electronic HIE that endures to
inform future HIE activities.
RTI will provide several interim reports
on progress and a final report in the
summer. A national meeting of all
participants will be held on March 5-6,
2007, in Bethesda, MD.
Ambulatory Safety and Quality
Initiative (pending 2007). This
open grant solicitation is to explore
the use of health IT and related
policies and practices to establish
and enhance patient-centered care in
ambulatory settings. The
components are:
- Improving Quality
through Clinician Use of Health IT.
- Enabling Patient-Centered Care
through Health IT.
- Enabling
Patient Safety and Quality
Measurement through Health IT.
E-Prescribing Grants (2006-2007).
These 1-year grants and contract are
to fulfill the Medicare
Modernization Act of 2003
requirement that the Secretary test,
review, and approve standards for
electronic prescribing for Part D
beneficiaries. Significant additional
work has been done on how eprescribing
improves the safety,
efficiency, and effectiveness of
healthcare. These grants are
excellent examples of public and
private partnerships that advance the
use of health IT to improve quality
and safety of care.
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Testing in the Real World
These projects constitute a real-world
laboratory for examining health IT at
work. They cover a variety of
applications. They also look at the
impact of HIT in specific clinical
settings and as applied to particular
health conditions. Some of the areas
being studied are as follows:
- Examining health IT effectiveness in
various types of information
exchange, including medical
referrals, transferring radiology and
other test results, and information
sharing among care "teams."
- Assessing the impact of e-prescribing
for different age groups and medical
conditions.
- Using health IT for patient safety
improvement, providing for "blame
free" reporting of adverse events and
close calls.
- Exploring health IT applications for
chronic diseases, especially diabetes
and asthma.
- Demonstrating a patient-centered
wellness application.
- Determining the effectiveness of
health IT in the emergency unit
setting.
- Using health IT in creating an
evidence base for treatment of
particular conditions.
Full Collaboration and Technical
Assistance to Communities and the
Industry. AHRQ shares findings, tools,
and technical support through the
National Resource Center for Health IT
(NRC). The NRC provides direct
technical assistance and consulting
services to AHRQ projects involved in
developing, testing, and using health IT
applications, with a particular focus on
addressing challenges to health IT
implementation in rural and small
community settings. In addition, the
NRC serves as the link between the
health care community at large and the
researchers and experts who are on the
front lines of health IT. As the central
repository for lessons learned from
AHRQ's health IT initiative, the NRC
encourages adoption of health IT by
disseminating the latest tools, best
practices, and research results from this
unique real-world laboratory.
Emerging Lessons. As the AHRQ
portfolio of health IT projects conclude
their implementation and research, they
are demonstrating the potential of
health IT to improve health and health
care. Their collective experience offers
an important learning opportunity for
other health IT implementations across
the country. Topics for which AHRQ
shares the lessons learned include:
- Knowing where to begin.
- Electronic health records.
- Computerized provider order entry.
- Clinical decision support.
- Health information exchange.
- Executive management.
- Leadership and project management.
- Cost and sustainability.
- Telehealth.
- Electronic prescribing.
Data, issues, and proposed best practices
gathered from a broad cross-section of
the country are now being compiled and
analyzed and can be used by HIE
developers, policymakers, and the health
care industry nationwide as they work to
build trust in electronic health data
exchange.
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More Information
For additional information on AHRQ
projects on health information
technology, go to http://www.healthit.ahrq.gov
or contact: Jon White, M.D., at
jonathan.white@ahrq.hhs.gov.
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AHRQ Publication No. 07-P006
Current as of February 2007
Internet Citation:
Health Information Technology: Overview. Program Brief. AHRQ Publication No. 07-P006, February 2007. Rockville, MD: Agency for Healthcare Research and Quality. http://www.ahrq.gov/research/hitover.htm
540 Gaither Road Rockville, MD 20850