Office of the National Coordinator — Time to Reorganize.

HHS

On December 1st, 2009 the Office of the Secretary of the Office of the National Coordinator (ONC) for Health Information Technology announced the creation of a new Chief Privacy Office and the Office of Economic Modeling and Analysis (among three others including the Office of Chief Scientist, Deputy National Coordinator for Programs & Policy, and Deputy National Coordinator for Operations).  The New Chief Privacy Officer is a necessary creation under the ARRA (and the HITECH Act).  This role is different from the other positions that seem to be a re-organization of roles and responsibilities that already existed to some extent just with more specificity around functions and duties.  Aside from the Chief Privacy Officer the New Economic Modeling and Analysis Position seems like a timely creation given recent articles discussing whether Health Information Technology and more specifically Electronic Health Record Systems (EHRs) actually reduce the cost of care and/or increase the quality of care.  Also of note, the new Office of the Deputy National Coordinator for Programs and Policy will be responsible for the open source Connect initiative and the National Health Information Network.

 (see http://healthit.hhs.gov/portal/server.ptopen=512&objID=1200&&PageID=15520&mode=2&in_hi_userid=10741&cached=true)

Below is a diagram detailing the new offices relative to the National Coordinator.

The Notice in the Federal Register note that the reorganization affects all four of the original Director-level offices:

• The Office of Health Information Technology Adoption (OHITA);
• The  Office of Interoperability and Standards (OIS);
• Office of Programs and  Coordination (OPC); and
• The Office of Policy and Research (OPR).

Five offices will have direct reporting capability to the National Coordinator for Health Information Technology (National Coordinator):

1. The Office of Economic Modeling and  Analysis (ARB);
2. the Office of the Chief Scientist (ARC);
3. The Office of the Deputy National Coordinator for Programs & Policy (ARD);
4. The Office of the Deputy National Coordinator for Operations (ARE); and
5. The Office of the Chief Privacy Officer (ARF).

(see http://edocket.access.gpo.gov/2009/E9-28755.htm).

The Office of the Chief Privacy Officer will advise the National Coordinator.  Chief Privacy Officer of the Office of the National Coordinator for Health Information Technology will be appointed by the Secretary.  The Office of the Chief Privacy Officer duties include:

1. Advising the National Coordinator on privacy, security, and data stewardship of electronic health information; and
2. Coordinating the Office of the National Coordinator for Health Information Technology’s efforts with similar privacy officers in other Federal agencies, State and regional agencies, and foreign countries with regard to the privacy, security, and data stewardship of electronic, individually identifiable health information.

The Office of Economic Modeling and Analysis responsibilities include:

1. Applying advanced mathematical or quantitative modeling to the U.S. health care system for simulating the microeconomic and macroeconomic effects of investing in health information technology; and
2. Providing advanced policy analysis of health information technology strategies and policies to the National Coordinator.

The purpose this position will be to model varying public policy scenarios to perform advanced health care policy analysis for requirements of the Recovery Act, such as reductions in health care costs resulting from adoption and use of health information technology.  The results of these analyses provided to the National Coordinator will inform strategies to enhance the use of health information technology in improving the quality and efficiency of health care and improving public health.

The Office of the Chief Scientist will be responsible for:

1. Applying research methodologies to perform evaluation studies of health information technology grant programs;
2. Identifying, tracking and supporting innovations in health information technology;
3. Leading research activities mandated under the HITECH Act provisions of ARRA;
4. Promoting applications of health information technology that support basic and clinical research;
5. Collecting and communicating knowledge of health care informatics from and to international audiences;
6. Collaborating with other agencies and departments on assessments of new health information technology programs; and
7. Developing and maintaining educational programs for staff of the Office of the National Coordinator and advising the National Coordinator concerning the educational needs of the field of HIT.

The Office of the Chief Scientist possesses and utilizes specialized knowledge of medical bioinformatics, which involves the study and application of advanced information methods and technologies in support of health care and population health.

The Office of the Deputy National Coordinator for Programs and Policy assumes functions previously performed by the Office of Health Information Technology Adoption, the Office of Interoperability and Standards, the Office of Adoption Provider Support, the Office of State and Community Programs, and the Office of Policy and Planning.  The new office will lead ONC programs related to health information exchange, regional extension centers, training of the health IT workforce, and the development of technical standards for interoperability, security, and certification of health IT systems.  The new office comprises:

1. The Office of Standards and Interoperability, with responsibility for standards, security, certification, the Nationwide Health Information Network, Federal Health Architecture and the CONNECT program;
2. The Office of Provider Adoption Support, which administers the Regional Extension Centers program and health IT workforce development;
3. The Office of State and Community Programs, which administers the state-level health information exchange program and the Beacon Communities Program; and
4. The Office of Policy and Planning, which is realigned to include all policy development, including privacy and security policy, and is liaison with legal affairs and legislative affairs, regulations development  and externally focused strategic planning.

The Office of the Deputy National Coordinator for Operations is responsible for activities that are vital to supporting ONC’s numerous programs and enhancing ONC’s ability to communication about health IT.