Congress increasingly is talking a good game about the need to significantly enhance interoperability of health information technology systems, but the funding purse remains closed for now.

For two years, the Obama administration has shot for the moon with its budget request for the Office of the National Coordinator for Health Information Technology—including a whopping $91.8 million for FY 2016. And for the third year, the initial budget proposal for ONC from the House is flat, about $63.387 million.

Also See: Big Bucks for ONC in President’s FY16 Budget Request

The House, where budgets originate although the Senate surely will have its say as well, also proposes termination of the Agency for Healthcare Research and Quality, effective October 1, 2015, when the federal FY16 budget year starts. However, agencies may after Oct. 1, with conditions, carry out activities of AHRQ that already are in progress, including activities in ONC and patient safety activities in the HHS Office of the Assistant Secretary for Health.

If the Senate goes along with a continuation budget—as it has the past two years—these are some of the new programs that ONC has proposed that may face the cutting block: Stage 3, Interoperability Roadmap, strategic investments to support development and testing of interoperability standards, IT support for the Precision Medicine Initiative, integration of prescription drug monitoring programs (particularly opiates) by leveraging health IT, and a health IT safety center. For now, Stage 3 is not going away as it is early in the budget process, but its financial future for the moment is cloudy.

Asked if a continuation budget would imperil ONC’s new initiatives, a spokesperson replied, “The President’s budget proposal identified the priorities needed to meet the goals and mission of achieving an interoperable, nationwide learning health system that ensures information flows safely and securely. If the House budget is finalized, we will need to look at the available funds and how to meet those priorities.”

The House likes President Obama’s $215 Precision Medicine Initiative and includes in its budget plan funds for the core $200 million effort to launch a national cohort of more than a million Americans that the National Institutes of Health wants to volunteer to share their genetic information. The health data will be used to expand cancer genomics research and to initiate new studies on how a tumor’s DNA can inform prognosis and treatment choices for patients.

However, the House budget appears not to include the $15 million in ancillary funds to support the initiative, including $10 million to modernize regulations to support development and use of molecular diagnostics, and $5 million to develop technology and define standards and certification criteria to enable the exchange of genomic data.

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