Marchibroda: Speed the plow

New grants totaling $22.3 million from the Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) will seed and nourish the work already under way in regions and communities across the nation to improve the safety, quality and efficiency of health care. The grants will boost 16 health information technology initiatives designed to create financially sustainable models for health IT adoption.

Grant funding, even in small amounts, serves as an important catalyst for such initiatives, which are growing by leaps and bounds nationwide. In the eHealth Initiative Foundation's recent survey of 109 state, regional and community-based health information exchange initiatives and organizations, 91 percent of respondents said securing upfront funding was a very difficult or moderately difficult challenge. And 46 percent of all respondents cited the federal government as a funding source.

Although each AHRQ grant represents just one component of a project's overall budget, the funding will stimulate private-sector investments and give stakeholders a chance to improve health care delivery in their communities. In addition, AHRQ will use the results to learn about what works and doesn't work with health IT implementations in clinical settings to add to the knowledge base of its National Resource Center for Health IT.

In congressional testimony last month, eHealth Initiative officials addressed the status of efforts to exchange health information and the challenges local communities face -- not the least of which is aligning financial incentives with quality and safety goals and technical capabilities. Adjusting incentives will allow state, regional and community-based health information exchanges to create business cases and sustainable models for information mobilization.

Among the 16 AHRQ awardees are 11 small, rural efforts that need special funding because many would not get off the ground without government support. Until value-based purchasing incentives for health IT become more prevalent, efforts that provide seed funding for collaborative projects will play a critical role.

The eHealth Initiative and its foundation have worked to tackle this funding challenge by encouraging buyers, providers and payers to develop a common set of principles for aligning incentives with other goals. This framework, which we call Parallel Pathways for Quality Healthcare, offers guidance to states, regions and communities exploring health information exchange as a foundation for quality, safety and efficiency in health care delivery.

In the grants announcement, AHRQ said the recipients were selected from a group of grantees that received health IT planning funds from AHRQ in 2004. The new funding will allow them to implement plans they developed under their earlier grants, including projects focusing on privacy and security.

The timing of the awards could not be better. The eHealth Initiative applauds these community efforts and the considerable role they play in moving us toward a higher quality, safer, more efficient national health care system.

Marchibroda is chief executive officer of the eHealth Initiative.

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