The Office of the National Coordinator for Health Information Technology on Monday released the final Federal Health IT Strategic Plan for 2015-2020, aimed at modernizing the nation’s health IT infrastructure beyond just electronic health records.
The plan results from collaboration between more than 35 federal offices, laying out the vision, goals, and actions that the government will pursue to achieve “high-quality care, lower costs, healthy population, and engaged individuals” through widespread use of all forms of health IT. Specifically, federal agencies are looking to “expand the ability of individuals to contribute electronic health information that is personally relevant and usable to their care providers so that both can use it effectively in health planning.”
While the prior 2011 plan primarily concentrated on EHR adoption, the updated 2015-2020 federal strategy attempts to leverage a variety of sources, platforms, and settings that generate electronic health information to inform health goals, behaviors, and decisions. This includes self-generated information collected through an individual’s mobile device, and non-clinical information collected by communities.
“Market innovations and policies that allow individuals to move and combine information from various sources—whether that information is stored in mobile applications, EHRs, or patient portals, into a single information source to improve health and wellness management—will greatly expand individuals’ capability to engage in self-management and contribute to improvements in healthcare, research, and technology innovation,” states the plan.
National Coordinator for Health IT Karen DeSalvo, M.D., told reporters in a press conference that the federal strategy puts people at the center with HIT in a supporting role designed to facilitate and enable delivery system reform, scientific advances like precision medicine, as well as improvements in public health and preparedness.
The focus on individuals is a significant change from the initial draft of the plan which critics charged was too heavily focused on providers while giving short shrift to consumers. However, Gretchen Wyatt, senior strategy advisor in ONC’s Office of Policy, emphasized that with the final plan “persons are really where we’re trying to go with the information.”
The plan includes four overarching goals: advance person-centered and self-managed health; transform healthcare delivery and community health; foster research, scientific knowledge, and innovation; and enhance the nation’s HIT infrastructure. “The end goal isn’t about health IT. The end goal is about making information available when and where it matters to improve health and wellness and to advance research and science,” said Matthew Swain, senior analyst in ONC’s Office of Planning, Evaluation, and Analysis.
“In a person-centered infrastructure, the term ‘health IT’ includes a wide range of continually emergent products, technologies, and services, including but not limited to modular EHRs, mobile and telehealth technology, cloud-based services, medical devices, integrated remote monitoring and virtual visits, risk-modeling and other predictive algorithms, assistive technologies, application program interfaces, and sensors,” states the federal plan.
Premier Inc., a healthcare alliance of 3,000 hospitals and 110,000 other providers, said it “strongly supports consumer access to health data in private, secure and meaningful ways through the use of apps and other tools that better enable achievement of health and wellness goals,” but at the same time “it is critical that the ONC fast track work to finalize interoperability standards necessary for capturing and exchanging information across IT platforms.”
Likewise, in a written statement, the College of Healthcare Information Management Executives said it endorses the overarching goals of the strategic plan, highlighting the need for health IT interoperability. “We cannot achieve the promise of population health and other advances in patient care without the ability to fully and securely exchange data,” according to CHIME. “This includes not just data between providers, but also establishing a framework for accepting the growth in patient-generated data.”
While the organization believes the Federal Health IT Strategic Plan is a “good step in that direction,” CHIME also argues that “we must attend to such issues as patient identification and development of functional electronic clinical quality measures.”
Among the barriers cited by the plan is a lack of steady and consistent access to advanced broadband Internet services, which “can lead to care gaps with consequences for patients that can be both burdensome and dangerous.”
In addition, the plan argues that while evidence suggests health IT improves patient safety, poor implementation or improper use can lead to adverse outcomes. “For the nation to collectively move to an expansive electronic health information environment, individuals, healthcare providers, and organizations need confidence that health IT solutions are secure, safe, and useful.”
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