HRSA - Conference on Health Information Technology

	U.S. Department of Health & Human Services Health Resources and Services Administration HRSA Press Office: (301) 443-3376 http://newsroom.hrsa.gov

Remarks to a conference on "Health Information Technology: A Rural Provider's Roadmap to Quality"

By HRSA Deputy Administrator Dennis Williams

September 21, 2006
Kansas City, Mo.

Good afternoon.

I’m very pleased to welcome all of you to this first-ever meeting on Health Information Technology and rural health care providers.

Health information technology – HIT – is a very hot topic these days in Washington because of its potential to cut health costs, reduce wasteful bureaucracy, limit medical errors, and improve health care quality.

In rural areas, we believe that HIT – and its potential for bringing together distant partners – can help rural providers overcome problems of isolation and scarce resources which they often confront.

In Pennsylvania, for example, the Susquehanna Health System has used HRSA telehealth grants to implement a regional electronic medical record system with three partner hospital systems in the rural North Central part of the state. Now all of the providers in the partnership can access electronic records on patients from any location. They have eliminated paper charts in physicians’ offices and emergency rooms, and have implemented digital radiography, completely eliminating the use of printed x-ray films. Imagine the time and energy they save by leaving paper behind and moving into the electronic age.

In Nebraska, a statewide telehealth network links 70 hospitals, 17 public health departments, six bioterrorism labs, and other state organizations through interactive, high-speed video and a data network. The network provides remote medical consultations, teleradiology, translation services and continuing medical education, and can be used to transmit alerts quickly during public health emergencies.

These are just two of several promising advances in HIT that are underway in rural America.

The Federal government’s involvement in HIT began in earnest in April of 2004. That’s when President Bush signed an executive order creating the Office of the National Coordinator for Health Information Technology and placed it in the Department of Health and Human Services, the Department of which HRSA is a part. The Office of the National Coordinator was given the lead in developing this national infrastructure.

At the same time, the President announced his commitment to develop and implement an interoperable, nationwide HIT infrastructure capable of assuring that most Americans have electronic health records within 10 years.

HHS Secretary Mike Leavitt made encouraging greater use of HIT a main priority when he assumed leadership of the Department early last year. The Secretary’s view of the future emphasizes the value of information and technology in improving the quality of health care and the management of disease.

At HRSA, Administrator Betty Duke has also made developing an information strategy an agency priority. To organize that strategy, last December she created the HRSA Office of Health Information Technology, and named Cheryl Austein Casnoff its director. Cheryl and her staff are working to make sure that HIT is integrated into HRSA programs that serve poor, uninsured, and special needs populations. Its scope is agencywide -- all of HRSA’s bureaus, offices and safety-net grantees will be involved in and benefit from its work.

Two of Cheryl’s staff are at this conference: Susan Lumsden and Christie Brown. Look for their sessions and talk with them.

Although the OHIT is new, HRSA involvement with HIT is not. For the past 10 years, we have been supporting Federally Qualified Health Centers and their use of this technology. Starting with PMS and moving more recently to EHR, we have found that networks of health centers help to reduce the cost and risk of these systems.

One of my first site visits when I came to HRSA four years ago was to Greene County, N.C. I visited Doug Smith, who is the head of Community Partners Health Net, a network of health centers in the state. Doug is here today – talk with him and learn from his experiences.

At HRSA, we’re proud of one of our first big HIT achievements -- a new interactive Web site we announced July 26, just half a year after the HRSA HIT Office was created.

It’s called the “HRSA Health Information Technology Community” and we developed it with our HHS colleagues at the Agency for Healthcare Research and Quality. A demonstration of the site will occur tomorrow morning at a 7 a.m. “coffee chat.” I know it’s early, but I recommend it to your attention. You also may catch a demonstration Friday evening at the “vendor exhibition.” Lisa Dolan Branton from AHRQ and Christie Brown from OHIT are doing the presentation.

The HIT Web site is a “virtual meeting place” for staff from Federally Qualified Health Centers, health center networks and Primary Care Associations. It focuses on technologies that promote patient safety and quality of care. People who log on can take part in online discussions, share documents, and exchange tools and resources on using health IT in community health care.

We believe that this educational and information-sharing role is one of the best ways that we can help grantees develop and implement their own HIT strategies. We’re not in the business of dictating the technology you should use, but we can provide information to help you make good business decisions about technology.

Since we unveiled the “HIT Community” site, HRSA has received more than 1,400 requests for user IDs from health centers and other primary health care grantees. That level of demand is a good sign to us that we’re on the right track.

The HIT Community site will soon add an online “toolkit” that offers advice on such topics as budgeting for HIT, funding opportunities, and how to use HIT to improve quality of care and program evaluations.

We’ll expand our Web-based assistance to all HRSA grantees in the near future. Other “virtual community” websites are in the early stages of development for grantees in our HIV/AIDS and Maternal and Child Health Bureaus.

And the HRSA HIT Office also has begun working with the HRSA Office of Rural Health Policy and our colleagues at AHRQ to create a virtual community for rural providers. We’re not very far along yet, but we’ll contact our rural health grantees by email once it’s ready to go online. We’re aiming for this coming winter.

In our view, HIT has a central role to play in improving the quality of the health care our grantees deliver.

When we talk about “quality” in programs that deliver direct health care, we’re talking about better health outcomes for patients. Outcomes are a straightforward way to measure quality. They’re direct. They’re easy to understand.

To improve outcomes, grantees must gather and critically analyze information on the patients they serve. We call that using information strategically, and it’s a phrase you’ll hear in tandem with HIT in the future.

In our view, data gathered on patient outcomes allow us – and you – to measure quality. If outcomes are poor, providers must identify problems in the delivery of care and take steps to resolve them. That’s what we mean by using information strategically. In this process of gathering and analyzing patient outcomes to improve quality, health information technology, obviously, will play a key role.

And you know HRSA is not alone in emphasizing quality. The Centers for Medicare and Medicaid Services, another HHS sister agency, is moving toward pay-for-performance in their programs.

Just as we’re working with health centers to help them tackle the task of implementing HIT in their operations, we want to listen to rural health care providers and work with you to shape and implement an HIT strategy for your operations.

That is why HRSA sponsored this conference. We want to bring together rural health care providers, organization executives, and HIT vendors to talk about using technology to improve the quality of health care.

Here let me restate Federal policy in regard to the HIT vendors you meet during the conference. The vendors who are here came as the result of an open registration process. We welcome them to the meeting, but neither HHS nor HRSA, nor any other Federal entity, endorses or recommends their products.

When HRSA put together the meeting’s agenda, we made sure to feature sessions that cover issues you need to consider in developing your own HIT strategy. These include:

Creating a vision and planning for HIT;
Choosing the right technology for your operations;
Financing the investment; and
Collaborating with others, building partnerships.

Don’t forget to consider state and local organizations as potential partners. In July, California Gov. Schwarzenegger allocated $240 million in state funds to develop HIT in rural areas and among safety-net providers and medical groups.

The Nebraska Telehealth Network I spoke about earlier is supported by $1.5 million annually in state funds. About $1.3 million in state matching grants supports an e-Health initiative in Minnesota to accelerate the adoption of HIT by providers in rural areas and underserved urban communities. And in Washington State, a public-private partnership makes $1 million available annually in grants that average $20,000 to help small physician practices and critical access hospitals invest in HIT.

Let me conclude now by thanking Tom Morris and his hard-working staff at the Office of Rural Health Policy for putting together this powerful agenda.

I encourage all of you to take full advantage of your time here. I ask you to roll up your sleeves and enjoy a wonderful learning experience with us and with each other. Thank you for your service to rural America. Have a great meeting.