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by HRSA Administrator Elizabeth M. Duke
November 5, 2007
Crystal City, Va.
Thank you for that wonderful introduction.
Two years ago HRSA didn't have an Office of Health Information Technology. Now we have 600 grantees in a giant convention hall, standing room only. 600 people who recognize the potential of HIT and how it can transform your operations and improve the services your organizations provide.
Two years ago HRSA didn't have a coherent strategy for investing in HIT. Now, in November 2007, I've just announced more than $55 million in grants to spur greater HIT investments and innovations at health centers and critical access hospitals.
Your attendance here shows me that you “get it” when it comes to HIT. And recent visits I've made to health care providers have shown me that they “get it,” too.
Two weeks ago I took some visiting government officials from Tanzania to a small rural hospital in Berkeley Springs, West Virginia, where they've implemented Electronic Health Records.
The next day we went to see an inner-city health center in Baltimore that's also using EHRs. It's a health center that's part of Salliann Alborn's Community Health Integrated Partnership (CHIP) Network in Glen Burnie, Md. That network just got a $1.4 million grant to expand their HIT investments.
Earlier today you heard from my deputy, Dennis Williams. This past summer he visited a small health center in Ft. Dodge, Iowa, where they, too, were using EHRs.
So it's a gathering trend, a movement in primary care that's beginning to really catch hold. It builds on the work of HRSA's telehealth grantees, who have for almost two decades used computer and telecommunications technology to bring medical care, advice and training to people and health professionals in the most remote locations. I visited some telehealth grantees in trips I made to Alaska and Hawaii not long after coming to HRSA, and I was really impressed at the improvements telehealth technology brought to people's lives in remote villages and frontier areas.
The movement also builds on the work of the health center network grantees and their peers whom Dennis honored earlier today. Those trailblazers developed and implemented some of the nation's earliest HIT strategies.
A reporter recently asked us, “Why is the Federal government investing in health information technology?” Our answer: “Because we believe health care for the poor shouldn't be poor health care.” That's why. And we're here today as part of our long-term strategy to educate you about the risks and opportunities of this technology so that you can make well-informed business decisions. We're here today to tell you we won't let you get left behind. And we're very glad you're here to learn more from the experts we've assembled for you over the next two days.
I know you'll learn from each other – and that we at HRSA will learn from you, as we always do. Many of the network and telehealth grantees, of course, have become experts and leaders in their own right. Some of our health centers are also successful adopters of this technology. For example, let me congratulate the Institute for Urban Family Health in New York City for the recent honor they received. In September the Institute, a health center grantee, was one of five winners of the prestigious Davies Award, which recognizes excellence in the implementation of the electronic health records.
At HRSA, we believe that networks work and that safety-net providers who come together to pool their resources and their expertise can achieve economies of scale that will lead to better outcomes for patients and reduce the risks that come with the implementation of any complex IT system.
Better health outcomes resulting from better quality of service is a big part of what we are all about at HRSA. Our emphasis on improving quality is just as strong as the emphasis we've put on expanding the health center system in recent years. We are committed to ensuring that the patients we serve get the safest, highest-quality care available in the American health care system.
Earlier I mentioned the $55 million in new HIT grants we recently announced. We're elated, of course, that we were able to find this seed money to expand the use of the new technology in health centers, in networks that link multiple health center grantees, and in rural communities with small hospitals.
But I do want to be open and honest from the beginning about these investments and the ones that will follow. These are time-limited grants meant to jump-start your efforts, spur collaboration and creativity, and build partnerships. They are meant to encourage health centers to join forces wherever possible and build economies of scale that will save you money in the long run – and quite possibly in the medium term, as well.
I'm saying this upfront because I don't want any misunderstanding about the intent of these grants. They are not the ‘first of many' grants that provide ongoing support; they are time-limited. We're happy to get you started, but you need to be able to sustain the effort, whether that means paying for hardware, software or technical assistance down the road.
To make it work, you'll need a hard-eyed sense of reality in your business operations. But that's something I know you already have. You already know how to persuade partners, find other sources of money, and come up with innovative strategies to reach your goals.
From our perspective, we want to move HRSA's HIT money out farther, to more programs and grantees across the country. So we can't – and we won't – keep funding the same scope of project to keep the momentum going. That would fight against our intention to make these funds go as far as they possibly can.
Grants are one part of our HIT strategy to help grantees design and implement their own HIT strategies. Education is another. We recognize that grantees are at various stages of research and implementation, and we think the best way we can help you is by sharing the best information we can assemble on HIT.
A little more than a year ago, HRSA joined forces with our colleagues at the Agency for Healthcare Research and Quality to create and put online the HRSA HIT Community Web portal.
As many of you know, the portal provides a “virtual” meeting place for users who share documents and exchange tools and resources on designing, implementing, and using HIT.
Grantees from across the country use it as a “communications hub” where they can go to have discussions online.
To date, about 2,000 health centers, primary care associations, and some maternal and child health grantees have logged onto and are using the site.
Cheryl and her staff soon plan to open the site up to additional HRSA grantees, including those from rural health, HIV/AIDS, telehealth and other MCH programs early next year, so stayed tuned for that.
Today, I'm delighted to be able to share with you our next big online educational effort, what we're calling the HIT Toolbox.
Information in the interactive toolbox will be organized into nine topic-specific modules that deal with different stages of HIT development and use. Among the topics covered will be modules on Opportunities for Collaboration; Planning for Technology Implementation; and Evaluating, Optimizing, and Sustaining.
We will share the Toolkit demo at the Collaboration Showcase later this afternoon, so I encourage those of you who are interested to attend.
The afternoon session also will feature a demonstration of HIT tools used by another sister agency, our colleagues at the Substance Abuse and Mental Health Services Administration.
And let me add here that HRSA works closely with staff in other HHS agencies to make sure the concerns of safety-net providers are raised whenever HIT is being discussed. Besides AHRQ and the Office of the National HIT Coordinator – our key HHS partners on HIT – we also work with the Department-wide Rural Workgroup to share our vision of how HIT can help reach isolated rural patients. Through these relationships, we make sure our Department partners are aware of the unique environment safety-net providers work in and the special populations we serve.
And we're in close touch with colleagues at the Centers for Medicare and Medicaid Services, and that includes working closely with states that recently received $150 million in Medicaid transformation grants. We also encourage all of you to reach out to these non-traditional partners.
We actually think we have an advantage in some of these internal discussions, because we argue that it's possible to do pioneering work in the relatively small systems that HRSA grantees administer. We provide care to populations that suffer disproportionately from chronic diseases and that need the best service possible to get well and prosper – and that includes services provided by others in the community. HIT can be an effective tool for integrating safety-net providers and their patients into the broader health care community. We argue that our clientele and our diverse working environments could well be an advantage in providing test markets for new HIT technologies and strategies.
Dr. Robert Kolodner, the National Coordinator for HIT, and his senior staff have visited health center sites in West Virginia and Chicago , and his office has contributed funds to our recent grants. So we feel confident our voice is being heard at the national policy level.
I said at the beginning of my speech that our emphasis on improving quality has been just as strong as the emphasis we've put on expansion.
Our emphasis on improving quality is why we've seen the increase in oral health and mental health services that treat the whole person. It's why we put so much effort into developing core clinical performance measures and updating program expectations. And it's why we made a review of the way health centers and other grantees collect data a central part of the agency-wide initiative to improve quality. Our goal is fewer reporting burdens for grantees and better outcome-focused data.
We want the data we collect to track individual and population health outcomes and point out our best performers so that all of us can learn from them. Grantees with good or improving patient outcomes can be models for others who are struggling to improve care. Our vision is to transform systems of care for safety-net populations by using HIT strategically – that is, to use the data to point the way to ongoing improvements in the health care our grantees deliver.
In support of that vision, I have a request. If any of you can link HIT practices you've implemented to better health outcomes and improved pharmacy services or patient safety, I urge you to call our Center for Quality.
The Center is working with Cheryl's office and others throughout the agency on a hunt for HRSA-supported organizations – like the eight Dennis honored this morning – that we can point to as top-performers. Right now we are in the study and planning phase of this effort, which we call our Patient Safety and Pharmacy Initiative.
Next summer we plan to showcase the top-performers we identify to hundreds of safety-net providers as part of a national peer-to-peer technical assistance effort aimed at generating rapid gains in health outcomes and patient safety and upgrades in clinical pharmacy services. So if you've done good work that you want us to shine a spotlight on as part of this national effort, please get in touch with HRSA staff at the Center for Quality.
We are here today because we are fascinated by HIT's potential. It can increase efficiency by reducing the current reliance on paper records and the need for so many administrative staff. It can improve patient safety and the quality of care by speeding access to patient information. It can prevent medication errors through electronic prescribing. It can bring health care to geographically isolated patients through telehealth.
The promise of meaningful change and progress wrapped up in those three letters – HIT – is why there's such a sense of hope and excitement in this room. The technology verges on magical.
None of us here today doubts that health information technology will transform health care in America . But HIT's full benefit will be reached only to the degree that we humans are able to listen to each other, plan well, and build the collaborative relationships needed to unlock its astounding potential. As we gain greater access to these wonderful new tools, we are responsible for using them wisely and effectively.
Thank you for listening. I wish you a great meeting.
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