By Neil Versel

June 10, 2008 | WASHINGTON—Health IT advocates in the private sector are giving qualified praise to a federal plan to sharpen the government’s focus on the twin goals of high-quality, cost-efficient, patient-focused health care and of improved population health.

“I like the topic areas,” Charlene Underwood, director of government and industry affairs for hospital systems vendor Siemens Medical Solutions USA (Malvern, Pa.), says of the “ONC-Coordinated Federal Health Information Technology Strategic Plan: 2008-2012.” released last week by the Office of the National Coordinator for Health Information Technology (ONC). “It had very specific objectives and it had tactics underneath it.”

The report stated that the federal government can help the nation achieve the two overarching goals by facilitating secure access to and exchange of electronic health information and continuing to promote adoption of electronic health records (EHRs) and personal health records (PHRs).

“Over time, as information begins to move among EHRs and PHRs, individuals will connect with their clinicians, clinicians will connect with other care providers, and health-related communities will connect with each other to enable the improvements in health and care that everyone wants,” according to ONC. “As these connections are made, the Nationwide Health Information Network, or NHIN, will evolve fully and provide communities across the entire nation with the ability to securely exchange electronic health information.”

The report says physician adoption of clinical information technology was at 14 percent in 2007, up slightly from 10 percent in 2005, and federal officials remain optimistic that they will achieve President Bush’s goal of providing interoperable EHRs to the majority of Americans by 2014.

For its part, the Healthcare Information and Management Systems Society (HIMSS) is reserving judgment on the full, 115-page report. Thomas Leary, HIMSS senior director of federal affairs, told Digital HealthCare & Productivity on Monday that HIMSS staff had not completed their exhaustive review of the strategic plan, and thus does not have an official position yet.

“From strictly a policy perspective, they’ve answered the mail,” Leary says, noting that the Government Accountability Office (GAO) said in 2006 that the nation would not achieve Bush’s objective in the absence of a coordinated strategy to get there. Last year, the Institute of Medicine (IOM) recommended that ONC develop such a plan. “They’ve met the requirements set out by the GAO, IOM, and industry,” according to Leary.

He says HIMSS will be looking at whether the timeline is realistic, if there are any pleasant surprises, and if ONC missed any key issues.

Leary calls the new strategy a refinement of the 2004 strategic framework set out by then-national coordinator David Brailer, which set out four objectives for achieving the president’s vision: inform practice, interconnect clinicians, personalize care, and improve population health. “If you look at Brailer’s four goals, they fit within the two boxes [of the new report],” Leary says.

While Underwood likes ONC’s leadership in coordinating health IT efforts among federal agencies, she is disappointed by the heavy emphasis on clinical standards and lack of discussion of administrative processes. “Where there’s coordination, it didn’t coordinate with other standards, such as on the financial side,” Underwood says, citing the slow but inevitable transition to the ICD-10 coding scheme and standardization of attachments to HIPAA-compliant claims.

“We have a whole financial transaction network that works,” Underwood says. “Why not think through how we can build on that existing network instead of starting from scratch?”

There also seems to be an inherent tension between population health and personalization of health information. “We’re always going to have to balance the public good with the private good,” Underwood says.

Additionally, Underwood wonders if ONC has a tactic regarding definitions of health IT terminology. In late April, the National Alliance for Health Information Technology sent ONC a list of proposed definitions for terms such as EHR and health information exchange.

______________________

Sign up for a free subscription to Digital HealthCare & Productivity.