Tracking Electronic Health Record Adoption and Capturing Related Insights in U.S. Hospitals

Significant federal investments to accelerate the adoption of electronic health records (EHRs) and exchange of clinical data are now in place.

It is critical to continue to track the adoption and use of EHRs and related insights to: (1) ascertain the status of adoption and evaluate existing and
proposed policy decisions; (2) evaluate the impact of ONC programs and related incentives for meaningful use; and (3) make resources available to ONC and external researchers to assess the effects of health IT adoption and exchange on key aspects of care, such as quality and efficiency.

The data generated under this funding opportunity will enable ONC and researchers to carry out these important activities for inpatient settings.

Agency - Department of Health and Human Services

The Department of Health and Human Services is the Federal government's principal agency for protecting the health of all Americans and providing essential human services, especially to those who are least able to help themselves.

Program Accomplishments

Fiscal Year 2016: No current data available. Fiscal Year 2017: No current data available. Fiscal Year 2018: No Current Data Available

Uses and Use Restrictions

Contract, Subgrants.

Funds under this announcement cannot be used for the following purposes: ? To supplant or replace current public or private funding. ? To supplant on-going or usual activities of any organization involved in the project. ? To purchase or improve land, or to purchase, construct, or make permanent improvements to any building. ? To reimburse pre-award costs. ? Indirect costs should not exceed 8% of direct costs.

FY15 ONC Appropriations.

Eligibility Requirements

Applicant Eligibility

This is a non-competitive funding opportunity and is restricted to a designated organization.

Organizations not designated as such are not eligible to apply for this opportunity, and therefore should not submit an application.

Applications submitted by organizations not designated below will not be considered.

The designated organization for this opportunity is the American Hospital Association (AHA).

Beneficiary Eligibility

The beneficiaries will include the Office of the National Coordinator for Health Information Technology, the American Hospital Association, and any researchers or members of the general public interested in survey data on the adoption and use of health IT by U.S. hospitals.


No Credentials or documentation are required. This program is excluded from coverage under 2 CFR 200, Subpart E - Cost Principles.

Aplication and Award Process

Preapplication Coordination

Preapplication coordination is not applicable.

Environmental impact information is not required for this program.

This program is excluded from coverage under E.O.


Application Procedures

2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards applies to this program.

Award Procedures

The Notice of Grant Award (NGA) is signed by the ONC Grants Management Officer. The successful applicants? Authorized Representatives will receive the NGA electronically from ONC. The NGA is considered the official authorizing award document. The NGA will include amount of funds awarded, the terms and conditions of the cooperative agreement, the effective date of the award, the budget period for which support will be given, the total project period timeframe, and the total approved budget.


Sep 10, 2015


Consolidated Appropriations Act 2017, Pub L No. 115-31, Division H, Title II and Title XXX, §§3001 (c)(2) and 3011 of the Public Health Service Act.

Range of Approval/Disapproval Time

From 60 to 90 days.


Not Applicable.


Renewals will be available if the Office of the Coordinator for Health Information Technology continues to report on hospital adoption and use of health information technology using these survey methods, and continues to be satisfied with the quality of the output.

Assistance Considerations

Formula and Matching Requirements

Statutory formulas are not applicable to this program. This program has no matching requirements. This program does not have MOE requirements.

Length and Time Phasing of Assistance

Funds will be available through the period of performance. Method of awarding/releasing assistance: lump sum.

Post Assistance Requirements


Reports will be developed by ONC Staff prior to award.

Federal Financial Report-Cash Transaction Reports are required quarterly in the Payment Management System.

Reports will be developed by ONC Staff prior to award.

Federal Financial Reports SF-425 are due semi-annually.

Reports will be developed by ONC Staff prior to award.


In accordance with the provisions of 2 CFR 200, Subpart F - Audit Requirements, non-Federal entities that expend financial assistance of $750,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Non-Federal entities that expend less than $750,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in 2 CFR 200.503. The Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS Awards, Subpart F, Audit Requirements sets forth standards for obtaining consistency and uniformity among Federal agencies for the audit of non-Federal entities expending Federal awards. In general, a non-Federal entity that expends $750,000 or more during the non-Federal entity?s fiscal year in Federal awards must have a single or program-specific audit. Subpart F provides further guidance including the manner in which expenditures are determined, the distinction between a single audit and a program-specific audit, frequency of audits, and roles and responsibilities in the conduct of audits.


No Data Available.

Financial Information

Account Identification



(Cooperative Agreements) FY 16 $0; FY 17 est $0; and FY 18 est $0

Range and Average of Financial Assistance

No Data Available.

Regulations, Guidelines, and Literature

2 CFR 200 Subparts B through D and F

Information Contacts

Regional or Local Office


Headquarters Office

Carmel Halloun 330 C Street SW, Washington , District of Columbia 20201 Email: Phone: 202-720-2919

Criteria for Selecting Proposals

The AHA has an ongoing data collection effort in place designed to capture information on the adoption and use of electronic health records, as well as users? attitudes towards them in U.S. hospitals. Since 2008, ONC has supported the data collection and acquired the resulting data through a single-source cooperative agreement. The AHA Annual Survey of Hospitals collects data from more than 6,300 hospitals through the U.S. This data is a primary resource for government agencies and has been used by the Centers for Disease Control and Prevention, the U.S. Census Bureau, and CMS. The IT Supplement currently reaches more than 3,500 hospitals in the U.S. The IT Supplement is a separate collection effort from the AHA?s general census tracking survey project that has been conducted continuously since 1946. Over this time span, the general census tracking survey has enjoyed an average response rate in excess of 75 percent. Such a high level of response is exceptional for a voluntary survey that includes both member and non-member hospitals. Building on the success of the general survey, the response rates for the IT Supplement have exceeded 60 percent each year since its inception, an exemplary response rate for a comparatively newer data collection effort. As the leading acute care hospital membership organization (approximately 80 percent of non-federal acute care hospitals are members), the AHA is uniquely suited to build on the response rate successes of prior years. Its credibility and reputation as a hospital advocacy and research center are unmatched by any other organization. In addition, the AHA has more than 60 years of experience in survey development and design and effective data collection through mail-based, and now Internet-based, efforts. In an effort to measure key components of interoperability, ONC has made it a priority to measure health care providers? ability to electronically send, receive, find, and integrate information received from outside sources. Without funding to supplement the cost of data collection, the AHA would not conduct an IT survey of this scope. ONC?s input on the survey instrument also allows the agency to track key performance measures regarding the interoperable exchange of health information by hospitals. The AHA?s IT Supplement is the only known source that tracks key performance measures regarding the interoperable exchange of health information by hospitals. Our national progress on interoperability also has direct implications on the success of federal initiatives such as delivery system reform and achieving ?widespread interoperability? as outlined in MACRA. Tracking and reporting on progress allows us to know where we are collectively starting from, how much progress we have made over time, and whether we have met important milestones. In addition, the AHA?s IT Supplement has the capability to track specific functionalities included or under consideration for future inclusion in federal programs (such as meaningful use). ONC?s ability to provide input on the content of the IT Supplement to measure interoperability and EHR functionalities is critical to informing and evaluating federal health IT policies and programs. This survey has served the public good in that it has been the foundation of important public research on EHR adoption, as well as examining the impact EHR use has on the quality and efficiency of care in inpatient settings. Examples of such studies include Holmgren et al. 2016, Lammers et al. 2016, Walker et al. 2016, and McLaughlin et al. 2015.

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