ONC seeks 52% budget increase for 2016

The Obama administration is requesting a 52 percent budgetary increase for the Office of the National Coordinator for Health IT (ONC) next year to support interoperability, “optimization” of health IT, consumer engagement in care and President Obama’s new Precision Medicine Initiative.

The budget President Obama submitted to Congress Monday for fiscal year 2016, which begins Oct. 1, seeks $91.8 million for ONC, up from $60.4 million this year. The money will support about 200 full-time jobs, up from the current 185.

ONC’s annual budget has been in the range of $60 million-$62 million since 2006, with the exception of a special $2 billion appropriation from the 2009 American Recovery and Reinvestment Act.

While it is unlikely the Republican-led Congress will give the president everything he wants even in an area like health IT that generally enjoys bipartisan support, the 2016 request signals a bit of a change in direction for ONC. While Meaningful Use, now in the second of three planned stages, remains important, federal officials are seeing that EHRs will not reach their full potential without interoperability, consumer participation in their own care and strong protection of patient privacy and security.

“Healthcare delivery in the United States is transforming from volume-based fiscal incentives towards an emphasis on enhanced value to the consumer. “In this new context, electronic health information is the essential ingredient to success,” the budget request said. While many healthcare providers have adopted health IT, putting electronic health information in the hands of the nation in a manner that is usable by all remains the primary goal.”

In a letter accompanying the Department of Health and Human Services’ budget document, National health IT Coordinator Karen DeSalvo, MD, MPH, MSc, said that ONC next year will concentrate on building a long-elusive interoperable, nationwide health IT infrastructure--one that “assures data can be securely and appropriately collected, shared with and used by the right people at the right time to achieve access to more affordable quality care and better health.” Also, DeSalvo wrote, “ONC will move toward health IT optimization to further care transformation and increase interoperability through policies, standards and programs that will continue to help providers and consumers leverage health IT.”

Some of ONC’s work will focus on implementing the federal government’s 2015-2020 health IT strategic plan, as well as its interoperability roadmap. Both documents should be finalized this year.

“It’s a natural progression for ONC,” Jeff Coughlin, senior director of federal and state affairs at HIMSS, told Clinical Innovation + Technology. He notes that health IT advocates asked Congress for more ONC funding during HIMSS’ annual policy summit in Washington in September.

About $5 million of the requested amount is related to the Precision Medicine Initiative, which Obama announced during the State of the Union address Jan. 20. That money will “support the development of interoperability standards and requirements that address privacy and enable secure exchange of data across systems,” according to the official document.

Interestingly, ONC is requesting all of the $91.8 million as Public Health Service evaluation funds rather than through ONC’s own budget authority, suggesting that the administration is framing health IT as a function of public health. “I think that’s indicative of how ONC has positioned itself under Dr. DeSalvo,” Coughlin said. Both DeSalvo and her immediate predecessor, Farzad Mostashari, MD, have backgrounds in public health.

“The administration is realizing where health IT fits in,” Coughlin said. “ONC [is acting as] the real coordinator of health IT across the federal government.”