ONC Issues Five-Year Federal Health IT Strategic Plan

The Office of the National Coordinator for Health Information Technology on Monday released its 2015-2020 Federal Health IT Strategic Plan laying out the federal government’s HIT priorities over the next five years.

The public has 60 days to comment on the draft plan, which was developed based on input from more than 35 federal agencies.

According to ONC, the 28-page plan “represents a coordinated and focused effort to appropriately collect, share, and use interoperable health information to improve healthcare, individual, community and public health, and advance research across the federal government and in collaboration with private industry.”

During a Dec. 8 briefing, Karen DeSalvo, M.D., national coordinator for health IT and acting assistant secretary for health, said the new plan differs from the current 2011-2015 plan in that the draft 2015-2020 strategy attempts to broaden its focus by moving health IT beyond EHRs to areas such as telehealth and mobile health, as well as trying to use policy and “incentive levers” beyond the Medicare and Medicaid EHR Incentive Programs.

“The current plan was written at the height of the work around HITECH, and a lot of our effort at that time appropriately was on thinking through how those levers—Meaningful Use, some of the grant programs, the Affordable Care Act—and particularly health IT stand at improving care delivery,” said DeSalvo. Now is the time to expand beyond healthcare organizations, as they impact only about 10 to 20 percent of somebody’s health, she added. “We really want to expand the universe of opportunities and think through how human and social services, how community inputs and organizations, how where people live, learn, work and play influences their health, and how we can expand the health IT ecosystem that would—where appropriate—be able to capture, share, and use that health information to the betterment of the people and the community.”

Among the federal government’s goals in the 2015-2020 timeframe is to expand the adoption of health IT. “Incentive payments dramatically accelerated broad use of EHRs by hospitals and providers. However, gaps and challenges remain for nationwide health IT use,” states the plan. “This goal aims to expand health IT adoption and use efforts across the care continuum, emphasizing assistance for healthcare providers serving long-term and post-acute care, behavioral health, community-based, and other populations ineligible to participate in the Medicare and Medicaid EHR Incentives Programs. In addition, this goal aims to expand the adoption and use of a broader set of technologies, including telehealth and mobile health.”

The plan acknowledges that while EHR adoption among hospitals and physicians has dramatically increased since the passage of the HITECH Act, health IT use remains low among providers practicing in long-term services, post-acute care, and behavioral health settings. “It is important to capture electronic health information from all sources in order to obtain a more complete picture of overall health,” according to the plan, which also points out that the use of telehealth and mobile health technologies remains low. “Greater use of these technologies has the potential to significantly impact the quality and cost of care,” the plan asserts.

DeSalvo emphasized that the federal government as a “purchaser, payer, provider and regulator” of the healthcare industry can advance “health IT-ness well beyond the few levers”  such as the Meaningful Use currently under its control with other opportunities across the public sector. She also said the Federal HIT Strategic Plan is meant to set the “context and framing” for ONC’s interoperability roadmap—slated for public release in early 2015—which will lay out how the federal government and private sector will approach sharing health information. “Interoperability is a crosscutting component of this plan, and implementation of the roadmap will be necessary to advance the plan’s goals,” argues the strategy document.

“The Federal Health IT Strategic Plan collectively represents specific goals and strategies for how interoperability will be leveraged to foster the technological advancement of health information exchange to improve quality of care,” said Gail Graham, deputy secretary for health informatics and analytics at the Department of Veterans Affairs, Veterans Health Administration, Office of Health Information, in a written statement.

“The success of this plan is dependent upon insights from public and private stakeholders and we encourage their comments,” DeSalvo said. The public has until Feb. 6, 2015 to comment on the Federal Health IT Strategic Plan. Based on feedback, a final plan will be released sometime next year.

In response to the plan, the eHealth Initiative issued a statement that ONC “has made significant progress in the last several years and this plan will be helpful for all healthcare stakeholders.” Bradley Merrill Thompson, general counsel for the mHealth Regulatory Coalition, tells Health Data Management that the plan is “generally on the right path” though he is “anxious to see more information,” particularly as it relates to the document’s Objective 1B: Increase user and market confidence in the safety and safe use of health IT products, systems, and services. 

“Like most strategic plans, this one is thin on details. But as a general matter, the stronger the ONC response to safety, the more FDA will be able to pull back on its oversight of health IT products,” says Thompson. “There's quite a bit at stake—both in the public health improvements that come with expanded use of health IT, but also in the public safety that results from careful assurance of quality in health IT.”

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