The chairman of the Federal Communications Commission gave details Tuesday of a pilot program to allocate $400 million in telephone user taxes over the next three years to promote the extension of high-speed telecommunications connections to as many as 6,000 healthcare organizations, targeting rural and medically underserved providers.
Kevin Martin made the announcement during a meeting of the American Health Information Community at the American Medical Informatics Association convention in Chicago. AHIC is a panel created in 2005 by HHS Secretary Mike Leavitt to advise him on healthcare IT policy.
Martin said the FCC will announce next week the awarding of grants to applicants that will extend broadband connectivity to providers in 42 states and three U.S. territories. Martin said the pilot program will leverage the work of state and regional health information exchanges to serve as hubs in a network of interoperability. While not all beneficiaries of the grant program will be providers in rural and medically underserved areas, "a significant portion" of them will be, Martin said.
Martin said broadband technology is key to economic growth and innovation and affects "almost every aspect of our lives," including healthcare, where "it is increasingly changing the way healthcare is delivered and received." In order for the U.S. population to extract the full benefits of the adoption of electronic health records and other healthcare information technologies, "providers must have access to broadband infrastructure," Martin said.
Martin said the pilot project was triggered by President Bush's April 2004 executive order that called on all government agencies to work to provide interoperable health information technology. Martin said the grants announced today represent a refocusing of an action the FCC initially took in September 2006, when it announced a Rural Health Care Pilot Program to provide basic Internet access to rural and underserved healthcare facilities. The new vision seeks to better promote connectivity between those same providerse.g., rural hospitals and clinics, public health agencies, community health centers and mental health facilitiesand other larger providers in their states or regions, Martin said. There were 81 applicants, Martin said.
Money will come from the universal service fee, a surcharge on telecommunications bills authorized under the Telecommunications Act of 1996. The tax also provides pools of funds to extend broadband connectivity to schools and libraries and to subsidize the cost of extending telephone service to rural areas. The grants will fund up to 85% of an applicant's costs to deploy a dedicated broadband network connecting healthcare providers in rural and urban areas within a state or region. The project also will fund up to 85% of the cost of connecting state or regional networks to the ultra high speed Internet2 and or National LambdaRail networks as well as the public Internet.
HHS is expending considerable time, effort and money to induce developers and users of healthcare IT systems to adopt data transmission standards for specific transactions, or "use cases" selected by the AHIC. Standards to implement the use cases are subsequently anointed by an HHS-funded Health Information Technology Standards Panel and incorporated into IT products by their specification in testing criteria by the federally supported Certification Commission for Healthcare Information Technology, which has certified 98 ambulatory and inpatient IT products.
Leavitt asked whether the FCC grantees could be compelled to adopt those standards and certified products. Martin said that probably was not possible under the Telecommunications Act, but compliance could come through work with the grantees by the Office of the National Coordinator for Health Information Technology at HHS.
"It is important that organizations participating in the pilot program use their resources consistent with the health IT initiatives being promoted by HHS," Martin said. "This includes implementation of an interoperable health IT systems and the use of certified IT products." In addition, Martin said providers will be expected "to coordinate with HHS and CDC during public health emergencies, such as pandemics or bioterrorism."
Leavitt, in an interview, said he was satisfied even though Martin could not commit to requiring grantees to comply with the AHIC/HITSP/CCHIT scheme as a condition of receiving FCC grant money.
"What he signaled very clearly was a willingness to utilize resources that are existing to drive a system that is connected, interoperable and patient-centered," Leavitt said. And while Leavitt said he didn't know the specific legal limitations Martin cited, "It seems there is plenty of room for collaboration and cooperation and he's indicated a desire for that to occur."
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