The Congressional Budget Office has estimated that it would cost $122 million over the 2017 to 2021 period to implement a bill that would require the Department of Health and Human Services to expand federal health information technology programs.

CBO said Friday the Senate’s Improving Health Information Technology Act would not affect direct spending or on-budget deficits through four consecutive 10-year periods beginning in 2027 and the legislation contains no intergovernmental or private sector mandates.

The bill would authorize the HHS inspector general to collect civil monetary penalties from entities that intentionally block access to electronic health information, CBO added.

Section 2 of the bill would direct the HHS secretary to recommend methods to lessen administrative
requirements related to the use of electronic health records as well as produce a strategy to implement the recommendations.

The HIT Standards Committee would be required to determine medical specialties and provider locations where health IT adoption is limited and provide recommendations on certifying criteria for pediatric health care providers’ HIT.

Implementation of section 2 would require four employees each year and cost $6 million over the 2017 to 2021 period, CBO said.

Section 3 of S. 2511 would obligate the Office of the National Coordinator for Health Information Technology to certify that accredited HIT developers do not willfully block access to electronic health information and ensure the seamless exchange of information between HIT systems.

The ONC will also create reporting requirements for HIT products; establish a star rating system for certified products; and publish rating criteria and star ratings for certified HIT products under the legislation.

CBO estimates that the implementation of section 3 would cost $43 million through the 2017 to 2021 period to cover 26 full-time employees each year as well as necessary IT and infrastructure.

Section 4 requires the HHS secretary to identify activities that constitute electronic health information blocking as well as issue a guidance on how to address barriers that prevent secure health information exchange.

This section would necessitate an average of 5 full-time employees every year and would cost approximately $6 million over the 2017 to 2021 period, CBO noted.

Section 5 would require 17 employees annually and cost $45 million over the 2017 to 2021 period as it directs ONC to collaborate with stakeholders to develop a trusted exchange framework that would contain policies and practices on privacy and security matters.

The bill’s section 6 would require certified HIT products to send and receive data from registries that collect information on individuals with specific medical conditions.

The section would also mandate HHS to submit a report to Congress on best practices related to the integration of HIT into clinical practice.

CBO said the enactment of section 6 would cost $8 million over the 2017 to 2021 period and require four full-time employees each year.

Under section 7, HHS would promote patient access to electronic health information through health care provider education as well as publish guidance on measures to provide health information to patients.

Section 7 would require four employees every year and cost $5 million from 2017 through 2021, CBO stated.

The legislation would require the comptroller general to produce several reports to Congress on the product rating system and on current initiatives that aim to match EHR to correct patients which would cost $1 million over the next four years.

Paula Yoon, director of the health informatics and surveillance division at the Centers for Disease Control and Prevention, has said CDC currently explores technologies as part of an initiative to modernize aging public health surveillance systems.

Yoon wrote in a blog post published Wednesday that CDC eyes application programming interfaces and microservices that could support the agency’s data collection and delivery efforts.

“CDC’s surveillance systems serve critical public health functions but many of our systems use aging technologies that have been patched together over time and need to be rebuilt or replaced,” Yoon said.

“We need systems that are less complex than the monolithic systems we use now, can easily be updated, and can be extended for multiple data collections purposes,” she added.

According to Yoon, CDC needs to use new methodologies such as agile development and DevOps to build, test and deploy systems as part of modernization efforts.

She said the agency should also increase oversight of information technology to secure systems and data and augment their capacity to handle automated iterative testing, discrete functionality monitoring, software updates and on-demand scaling.

The director added CDC needs to boost its IT workforce as well as update IT contract procurement and management practices because current rules and funding cycles pose challenges to IT project coordination and systems transition between contractors.

The Department of Health and Human Services‘ IDEA Lab initiatives, such as the Entrepreneurs-in-Residence program, support CDC’s efforts to address challenges, according to Yoon.

She noted that a software architect and a data architect from the EIR program have partnered to form a team to pilot and test new software; develop a metadata repository to coordinate and standardize data; draft blueprints to guide future software development; and create processes to optimize collaboration across CDC.