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According to ONC officials, the plan seeks to develop a cohesive blueprint that brings together federal efforts such as the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and investments in broadband for healthcare institutions; state and local projects supporting information exchange; and investments made by hospitals, physician offices, and critical access hospitals to accelerate the adoption of digitized medical records. Electronic health information is also important to support the implementation of new payment models, such as accountable care organizations (ACOs).
"The coordination of these efforts is complex, involving collaboration between dozens of government agencies and significant financial investments. I am sympathetic, therefore, to the question I've heard many times over the past two years: 'how does it all fit together?'" said David Blumenthal, national coordinator for health IT, in the report, which was released March 25.
Despite evidence of the benefits of health IT, ONC estimates that only 25% of physician offices and 15% of hospitals take advantage of EHRs.
Originally published in 2008, the strategic plan is being updated to reflect two major pieces of legislation enacted over the past two years: the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Affordable Care Act (ACA). These laws are dramatically changing the health IT landscape by providing an opportunity to modernize the way care is delivered and improve the health of all Americans.
According to Blumenthal, the plan has five main goals, some of which are familiar, including the Medicare and Medicaid EHR Incentive Programs and the grant programs created by the HITECH Act, which are building an infrastructure to support meaningful use. However, the plan also charts new ground for the federal health IT agenda:
In a statement on ONC's website, Blumenthal describes the five goals:
-- Goal I focuses on first fostering business models that create health information exchange (HIE), support exchange where it is not taking place, and ensure that information exchange takes place across different business models.
-- Goal II focuses on how integral health IT is to the National Health Care Quality Strategy and Plan required by the ACA.
-- Goal III highlights efforts to step up privacy and security of health information. It discusses a major investment in an education and outreach to increase provider and public understanding of electronic health information, how information can be used, and privacy and security rules and rights under the Health Insurance Portability and Accountability Act (HIPAA).
-- Goal IV recognizes the importance of empowering individuals with access to their electronic health information through tools that move toward more patient-centered care.
-- Goal V outlines development of a "learning health system" that can aggregate, analyze, and leverage health information to improve knowledge about healthcare across populations.
The updated plan starts in 2011, the year that Blumenthal describes as when medical care entered "the age of meaningful use." The plan builds on the foundation of meaningful use, which promises to transform the healthcare system by improving the flow of information by using health IT.
The plan addresses how ONC will work with federal partners and the private sector to use health IT data to: enhance the study of care delivery and payment systems; empower individuals to participate more in their care; and improve care, efficiency, and population health outcomes through tools such as clinical decision support, real-time feedback of performance to clinicians, and targeted public health campaigns.