Health Information Technology (HIT) Capacity Building for Monitoring and Improving Health Outcomes along the HIV Care Continuum ¿ Capacity Building Sites
This announcement will solicit applications for the fiscal year (FY) 2014 Health Information Technology Capacity Building for Monitoring and Improving Health Outcomes along the HIV Care Continuum ¿ Capacity Building Sites. The purpose of this program is to support four (4) current grantees of record awarded under the Ryan White HIV/AIDS Program Parts A or B to enhance the health information technology (HIT) systems in their States or Eligible Metropolitan Areas (EMAs) or Transitional Grant Areas (TGAs). These enhancements will allow a State or EMA/TGA¿s HIT infrastructure to more fully integrate and utilize relevant measures of HIV treatment, surveillance, laboratory and other program data, in order to build the HIV Care Continuum (formerly known as the HIV Treatment Cascade) for people living with HIV (PLWH) in their jurisdictions. The HIV Care Continuum¿s potential to become a key tool in assessing treatment outcomes and program effectiveness can only be fully met when State and EMA/TGA grantees have the capacity to efficiently utilize the Continuum¿s measures from all relevant HIV data systems in their jurisdictions.  State and EMA/TGA grantees who are better equipped to integrate and utilize the Continuum¿s treatment, surveillance and laboratory measures, can improve their monitoring of health outcomes along the HIV Care Continuum.  Optimal use of the HIV Care Continuum will allow States and EMA/TGAs to better target interventions for HIV-infected subpopulations experiencing disparities, and more efficiently utilize resources to improve health outcomes among PLWH. This Special Projects of National Significance (SPNS) Program HIT capacity building initiative aligns with Goal 2 of the National HIV/AIDS Strategy (NHAS[1]), to increase access to care and improve health outcomes of people livening with HIV/AIDS; and with Goal 3, to reduce HIV-related health disparities.  On July 15, 2013, the Office of National AIDS Policy (ONAP) marked the third anniversary of the release of the National HIV/AIDS Strategy by announcing the new HIV Care Continuum Initiative[2] authorized by an Executive Order of the President.[3] The Initiative directs Federal agencies to prioritize the continuum of HIV care by accelerating efforts and directing existing Federal resources to increase HIV testing, services, and treatment, while improving patient access to them. In the Ryan White HIV/AIDS Treatment Modernization Act of 2006, the SPNS Program was given authority to provide funding for Ryan White grantees and providers to develop standard electronic client information data systems to improve their capacity to report grantee-level and client-level data to HHS. This new initiative will build upon and expand SPNS¿ previous HIT capacity building efforts for Ryan White grantees to utilize integrated clinical, surveillance, laboratory and other program data to improve health outcomes among PLWH, as part of ONAP¿s HIV Care Continuum Initiative and in support of the National HIV/AIDS Strategy. To produce HIV Care Continuum models for HIV-infected subpopulations in their jurisdictions, applicants will be expected to leverage existing HIT systems and resources in their capacity building proposals. Some States and EMA/TGAs may already have their network of service providers integrated with each other through various HIT configurations, such as a Wide Area Network (WAN), a Regional Health Information Organization (RHIO), a central data repository, a Health Information Exchange (HIE) or combinations of these. However, the degree of integration with regard to interconnectivity may vary across disparate systems in States and cities, due to a variety of technological and organizational challenges such as different HIT standards and regulatory requirements.  Interconnectivity issues may include the varying ability of stakeholders to transmit data in real-time, or storing data in a local system and forwarding it in batches on a regular basis to a central repository. Enhancements for interconnectivity may be internal, such as adding new nodes to an existing network, or external, such as connecting two or more systems to facilitate data exchanges. Improvements to interoperability may include the implementation of better communication methods, including Continuity of Care Documents (CCD), transmission control protocols, secured web services, file transfer protocols, and others. Optimum interconnectivity should enable real-time, bi-directional tracking of client medical and support service data from one point of service to another, following standards that have been widely disseminated by the Office of the National Coordinator for Health Information Technology (ONC).[4] Thus applicants may propose various methods to improve the capacity of their State or EMA/TGA HIT infrastructure to enhance their ability to produce HIV Care Continuum models for HIV-infected subpopulations in their jurisdictions. These methods may include but are not limited to, interconnectivity improvements for an existing WAN, RHIO or HIE, and the development of a new or enhancement of an existing central data repository.  A central data repository can serve as the backbone of a HIE system, acting as the host location for access and sharing of data to effectively monitor and track health outcomes of PLWH. An effective centralized data repository will collect data from all relevant data sources in a given State or City, including State or local HIV surveillance and HIV testing databases, HIV treatment provider organizations, associated laboratories and other pertinent data systems. [1] Office of National AIDS Policy. National HIV/AIDS Strategy for the United States.  The White House, ONAP, July 2010. Available from: http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf [2] Accelerating Improvements in HIV Prevention and Care in the United States through the HIV Care Continuum Initiative. Fact Sheet, Monday, July 15, 2013. Available from: www.aids.gov/federal-resources/national-hiv-aids-strategy/hiv-care-continuum-initiative-fact-sheet.pdf [3] The White House. Executive Order ¿ HIV Care Continuum Initiative, July 15, 2013. Available from:  http://www.whitehouse.gov/the-press-office/2013/07/15/executive-order-hiv-care-continuum-initiative [4] See http://www.healthit.gov and http://www.healthit.gov/providers-professionals/standards-interoperability
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