ONC Federal Health IT Strategic Plan: Comments filed on behalf of the Society for Participatory Medicine

We e-patients are an impatient lot, and therefore we may not be big fans of the Five-Year Plan approach to creating change.  The Office of the National Coordinator for Health IT released a draft federal health IT strategic plan in late March, via blog post (the plan itself is linked to from the post; a copy is posted here).

The ONC post says:

The Plan demonstrates how we will build off the foundation of meaningful use to unlock the power of information to:

• Enhance our ability to study care delivery and payment systems
• Empower individuals to improve and participate more in their care
• 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

The Plan has five Goals, laid out in the post.  The Society’s comments on the ONC Strategic Plan focus on one of these Goals.  A brief excerpt follows:

Our comments focus on Goal IV of the Federal HIT Strategic Plan – “Empower Individuals with Health IT to Improve Their Health and the Health Care System.” This Goal breaks down into three Objectives, and a number of Strategies to achieve each Objective. The Goal and Objectives are laudable, but we would seek to strengthen the Strategies — by involving patients in the development of the system — so as to increase the likelihood of achieving the Goal in a meaningful way, and to do so sooner than five years from now.

One overarching comment on this Goal is that it is not integrated with the concept of care coordination, which is discussed elsewhere in the strategic plan. In order to fully realize the goal of patient centeredness, the patient must be involved in the coordination of his or her care. This omission highlights the perspective of the ONC on health care as something that is provided to patients rather than as a partnership process that involves patients, clinicians and non-professional caregivers. The patient-centeredness criteria promoted as part of the proposed rule on Accountable Care Organizations should be incorporated into the Strategies used to achieve this Goal. While these criteria are not all health IT-specific, the ONC makes the point in the strategic plan that that health IT enables patient empowerment, transparency, and achievement of the Triple Aim. Thus, all process, systems and standards improvements called for in the patient-centeredness portion of the ACO rule should be brought to bear on the health IT strategic plan.

(You may read more on this last topic at an earlier post on ACOs and patient-centeredness.)

The Objectives in play here are as follows:

• Engage individuals with health IT
• Accelerate individual and caregiver access to their electronic health information in a format they can use and reuse
• Integrate patient-generated health information and consumer health IT with clinical applications to support patient-centered care

Can’t argue with the Objectives; as noted above, though, some of us e-patients are impatient, and would like to see these Objectives reached sooner rather than later. 

One key thread running through our comments is that policymakers must remember that health care is not something done to patients, it is something done with patients, so a strong patient voice must be heard, and must be built into the system.  This is the time to do it, as we are framing out a brave new health care system.

Finally, as an added incentive to read the comments, please note that they include a link to a post by Regina Holliday containing her explication of a recent allegorical painting of hers — well worth the read, as it is an eloquent statement of the health IT and patient engagement issues at hand.

David Harlow
The Harlow Group LLC
Health Care Law and Consulting

This post first appeared at e-patients.net, the blog of The Society for Participatory Medicine.  Please check out the blog, the site, the listserv, and consider joining the Society.