Tuesday, June 3, 2008

ONC roadmap - On the road to Abilene?

Today, Rob Kolodner, Office of the National Coordinator (ONC) for Health Information Technology, released ONC's strategic plan for the next 5 years.

The ONC synopsis focuses on 2 goals: Patient-focused Health Care and Population Health. ONC defines Patient-focused Health Care as "enabling the transformation to higher quality, more cost-efficient, patient-focused health care through electronic health information access and use by care providers, and by patients and their designees." Population Health "enables the appropriate, authorized, and timely access and use of electronic health information to benefit public health, biomedical research, quality improvement, and emergency preparedness." Themes of privacy and security, interoperability, adoption, and collaborative governance apply to each of these goals.

Critical mass in the use of CPR's combined with exchange of health information between providers and access to information by patients will be facilitated by the Nationwide Health Information Network.

ONC defined the criteria for success as:
  • Health IT becomes common and expected in health care delivery nationwide for all communities, including those caring for underserved or disadvantaged populations;
  • Your health information is available to you and those caring for you so that you receive safe, high quality, and efficient care;
  • You will be able to use information to better determine what choices are right for you with respect to your health and care; and
  • You trust your health information can be used, in a secure environment, without compromising your privacy, to assess and improve the health in your community, measure and make available the quality of care being provided, and support advances in medical knowledge through research.
Is this The road to Abilene? Or the road to a better health system? Will health systems revolt over the massive investments needed to deploy enterprise systems, where many of the benefits don't accrue to the providers? Or can investments and benefits be better aligned? And will Health Information Organizations be sustainable?

There is solid momentum and engagement by HHS, healthcare providers, and healthcare IT companies. As an example of the energy level, CCHIT just reported that they had over twice as many volunteers as available roles in unpaid positions. There's clear value to patients and public health if these goals can be achieved.

Certification Commission for Healthcare Information Technology (CCHIT) chair Mark Leavitt has talked about the critical need to address the mis-aligned costs and benefits in the health system. Leavitt positions CCHIT as the enabler to a more virtuous cycle. The critical ingredient still missing in this equation is provider incentives of sufficient substance to close this loop. Whether this is the Road to Abilene or not, depends on whether providers can buy in at a reasonable sustainable cost.

1 comment:

Dean Cheatham said...

The road to Abilene, indeed.
The difference here is that everyone WANTS to Make the trip toward electronic patient records, but no one is quite sure HOW to make the trip...much less how to survive the heat that we'll encounter en route.

In my mind, we're almost putting the cart before the horse in trying to get a national health record in place - MANY individual healthcare organizations still do not have an electronic clinical system in place (or at least one that houses >50% of the patient record), so trying to tie places like this together seems a bit of a waste.

Is a strictly serial method of attack the way to go? No, but while we're moving ahead in parallel I think individual facility system implementations and adoption should take primacy over the "nationwide" topic for the next few years. Then, once we get enough pieces/parts in place, perhaps primacy can be shifted to the national level.

Until things get much better, I'll simply continue to carry a thumb drive labeled, "Pt_Record.txt" with a text file on there that chronicles my medical history. No DICOM images, no EKG traces...just the facts.