ONC Lays Out Vision, 10-Year Plan for Nation's Health IT Future

FPs Face Interoperability, Usability Challenges, Says AAFP Expert

June 16, 2014 01:35 pm Sheri Porter

HHS' Office of the National Coordinator (ONC) for Health Information Technology recently released a 10-year work plan(www.healthit.gov) designed to ensure that the United States will enjoy the benefits of an interoperable health information technology infrastructure by the end of the next decade.

"We have heard loudly and clearly that interoperability is national priority," said ONC head Karen DeSalvo, M.D., in a related blog(www.healthit.gov).

"We also see that there is a tremendous opportunity to move swiftly now," DeSalvo added, noting that consumers want their health care data to follow them across care settings and that employers, payers and health systems increasingly look to electronic data-sharing as a way to save time and money and improve quality.

Ditto for physicians. "Clinicians are ready for data to enable and inform care and improve their efficiency," said DeSalvo.

As for the AAFP, the Academy will continue to do its part on behalf of family physicians, said Steven Waldren, M.D., director of the AAFP's Alliance for eHealth Innovation (formerly the Center for Health IT). He told AAFP News that the Academy had been working with the private and public sectors to drive interoperability for 10 years.

Story highlights
  • The Office of the National Coordinator (ONC) for Health Information Technology recently released a 10-year work plan that outlines the nation's path to an interoperable health IT infrastructure.
  • ONC head Karen DeSalvo, M.D., wrote in a related blog that interoperability is a national priority and that the time is right to move decisively on the issue.
  • The AAFP's lead IT expert said the Academy had been working with various players to drive interoperability for the past 10 years and was willing to "re-up" for another decade of work.

"We are willing to re-up for another 10 years," said Waldren. He added that the AAFP's focus must stay not only on interoperability but also usability of the electronic health record (EHR) systems that family physicians increasingly rely on in their day-to-day patient encounters.

"Interoperability and usability are two of the biggest health IT challenges our family physicians face," said Waldren.

Work Plan Highlights

The ONC report, titled Connecting Health and Care for the Nation: A 10-Year Vision to Achieve an Interoperable Health IT Infrastructure, springs from the nation's overarching need for a health IT system that allows patients, families and physicians to have easy access to health information that

  • facilitates informed decision-making,
  • supports coordinated health management,
  • allows patients to be active partners in their health care and
  • improves the overall health of the population.

Report authors point to the "dramatic advancements" made in the past decade that have led to digitization of the nation's health care delivery system. For example, more than half of office-based physicians and other health care professionals and about 80 percent of hospitals currently use EHRs with sufficient functionality to qualify those users as "meaningful users" of the technology.

In addition, more than half of the nation's hospitals are able to search electronically for patient information housed beyond their organization or health system. And all 50 states have some form of health information exchanges services.

The ONC listed nine principles that will guide the planning and execution of the long-range plan. During the next decade, the ONC pledged to

  • build on existing health IT infrastructure to maximize the investments already made,
  • recognize that one size does not fit all and that users have different needs,
  • empower individuals to become active partners in their health care,
  • leverage a market that is demanding interoperability of health IT users,
  • keep solutions as simple as possible,
  • maintain the modularity of health IT to encourage innovation without having to overhaul entire systems,
  • support the varying skill levels of those who use health IT,
  • focus on value to at least offset the cost of health IT investment, and
  • protect privacy and security.

In her blog, DeSalvo discussed the five critical building blocks that will form the basis of the 10-year health IT plan.

She said that a nationwide interoperable health IT infrastructure must have core technical standards and functions; certification to support adoption and optimization of health IT products; privacy and security protections for health information; supportive business, clinical and regulatory environments; and rules of engagement and governance.

"These building blocks are interdependent, and progress must be incremental across all of them over the next decade to realize this vision," said DeSalvo. "We will collaboratively develop use cases and goals for three, six and 10-year timeframes that will guide work in each of the building blocks."

The report itself notes that the ONC will promote competition among network service providers "in a way that avoids providers or individuals being 'locked in' to one mechanism to exchange health information."

Plan Is Achievable

But is all of this possible within the timeframe the ONC has laid out?

"Achievement of the ONC's health IT goals for the nation hinge on payment reform," said Waldren. "If the financial models for health care reward the triple aim that we're all shooting for -- improving population health, enhancing the patient experience and controlling health care costs -- then interoperability becomes a business imperative.

"With that in mind, I believe this timeline is achievable because we have the technical building blocks to make this happen, and we are beginning to see the necessary changes in the health care delivery payment models," concluded Waldren.

Related AAFP News Coverage
2013: Year in Review
Family Physicians Embraced Health IT, Worked Through Challenges, Cheered Success
(1/2/2014)

Q&A with Farzad Mostashari, M.D., M.S.
Office of the National Coordinator for Health IT Tackles Pressing EHR Issues

(6/12/2013)

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