ONC releases 5-year plan for health IT


The Health and Human Services Department's office of the national coordinator for health information technology has identified five goals that will lead to the transformation of healthcare over the next 5 years: information exchange through meaningful use, improved cost and care, confidence in health IT, enablement of better health outcomes and advancement in health learning.

The agency released its "Federal Health IT Strategic Plan 2011-2015" (.pdf) Sept. 12. This plan updates the first Federal Health IT Strategic Plan, which was published in June 2008 and represents a final version of a draft plan released for comment March 25. In order to meet the objectives laid out in the plan, ONC says it will need considerable help from federal agencies, states and healthcare providers.

"There are a few well-defined barriers that have slowed acceptance of EHRs and widespread information exchange," acknowledges the plan. In order to advance EHR use, costs must decrease and IT support/training must improve, it adds. There is also no interoperable infrastructure to securely exchange health information nationwide--a necessary component for advancing EHR use that can be led by government.

Better health outcomes and costs will be driven in part by programs underway at ONC which aim to combine "more sophisticated uses of health IT and clinical care redesign" to "improve health system performance," notes the plan. This will create new standards of care, such as using clinical decision support tools, patient registries and reminder systems.

The success of health IT efforts rely greatly on the trust individuals place in health IT tools. The federal government must evaluate and update policies and programs with an eye toward privacy and security over the next 5 years, according to the plan. The government will leverage Fair Information Practice Principles and the Nationwide Privacy and Security Framework for Electronic Exchange of Individually Identifiable Health Information in assessing policy changes, it adds.

Observers can also expect an EHR certification program from ONC. The program will "facilitate the creation of clinical EHR systems that can accept information from consumer applications"--a move ONC hopes will ensure engagement beyond the current use of grants and contests.

These goals all drive what the plan refers to as a "learning health system," an environment teeming with healthcare data that can be sliced, mashed and shared in various, immediate ways. If achieved, a learning health system promises to make the right information available to support any given decision, "whether it is about the efficacy of a treatment or medication for an individual patient, predicting a national pandemic, or deciding whether to proceed with the research and development for a potential new treatment," explains the plan.

The strategy draws from the strategic framework laid out by the HIT Policy Committee, as well interviews with federal and private-sector experts, says the document. The draft received 240 comments, which were incorporated into the strategy, according to an HHS blog post from ONC Office of Policy and Planning Director Jodi Daniel. Many comments revolved around privacy, consent management, usability of electronic health record products, and the pace of change and timing for Stage 2 meaningful use rules.

Based on public feedback, HHS established a "principal-level, inter-division workgroup to develop an updated approach to privacy and security policies," around data-sharing permissions, for example. The plan also notes that stage 2 of meaningful use rules won't be in effect until 2014, as recommended by the Centers for Medicaid & Medicare Services. In response to public comments, ONC plans to support the National Institute of Standards and Technology's research as a guide for effective EHR products, explained Daniel.

"The plan is meant to be a living document that will be updated based on experience with stage one of the meaningful use electronic health record (EHR) incentive programs and the results of our evaluation program," she wrote. 

Daniel said ONC will closely track progress in meeting strategic goals, "particularly the high-priority goal for providers to adopt and become meaningful users of certified EHR technology."

Daniel also said ONC is seeking more information from the public on outreach and education that should be provided to healthcare practitioners and consumers. Consumer-focused efforts began immediately following the publication of the strategy.

A Sept. 12 proposed rule (.pdf) revises the Clinical Laboratory Improvement Amendments, making it easier for patients and authorized personnel to access lab test results. The proposed rule also impacts the Health Insurance Portability and Accountability Act by allowing patients to obtain tests directly labs.

For more:
- see the strategic plan (.pdf)
- see the HHS blog post

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