Terry’s June 23rd blog post on the Office of the National Coordinator for Health IT (ONCHIT) 10-Year Vision highlighted the 3-year, 6-year, and 10-year HHS targets for health IT (HIT). His post noted that Primary Care Providers (PCPs) are the central focus for many HIT reporting activities related to Meaningful Use (MU). While PCPs will continue to be a provider focus for HHS, facilitating patient engagement in HIT activities is central to planned ONCHIT activities and incentives. In the future HIT will be patient-centered.
Current findings
In 2013 the Agency for Healthcare Research and Quality (AHRQ) received recommendations from JASON, a group of scientists convened to provide council to the government on science and technology issues. The report, “A Robust Health Data Infrastructure,” defines the main goals for HIT: improved health care and lower health care cost. In the “discovery phase” of the report preparation, the JASON group identified why U.S. healthcare has lagged behind in the use of digital technology. Here are some of their findings:
- In general Electronic Health Records (EHRs) and Health Information Exchanges (HIEs) are “woefully inadequate” in what they provide to health care professionals
- Today data collection is intrusive in the workflow
- The MU interoperability requirements are inadequate
- Vendor proprietary issues are a barrier to progress
- There is no consensus on data standards
- Personal health records should be continuous, not episodic
Building blocks
The ONCHIT publication, “A 10-Year Vision to Achieve an Interoperable Health IT Infrastructure,” includes “Building Blocks” that address health care digitalization barriers documented in the JASON report.
- With a direct reference to the JASON report, Building Block #1 addresses data standards requirements. HIT data will have standard terminology, vocabulary, content, content format, transport, and security. Such standardization paves the way for creating a common HIT data “ecosystem” where all data is potentially accessible by permission.
- Building Block #2 outlines a process for specific certification of standard content and transport of HIT. In addition to functionality, EHR certification will support the data exchange and interoperability ONCHIT agenda.
- Building Block #3 identifies HIT requirements to be patient-centered. Patients will direct their personal health information through data input, oversight, and access authorization.
- Building Block #4 is an overview of changes in policy and incentives that will encourage HIT interoperability, exchange, and patient engagement.
- Building Block #5 establishes nationwide HIT governance in anticipation of a national HIT data “ecosystem.”
A patient-centric future
This HIT evolution over the next 10 years must be transformative. The JASON report includes a great quote from W. Edwards Deming, “If you invest in automating bad things, you just make bad things happen faster.” It is not enough for HIT to create a digital medical record with speedy information exchange. Creating patient-centered digital health records as an account in a vast HIT ecosystem of data can transform patient care. Each patient record may contain details that range from personal fitness to genomic data without health care organization boundaries. Patients will have the authority to permit instant data access to providers of choice. Providers will have the opportunity to access big, comprehensive data sets. The role of the EHR will be to provide a user-friendly interface for data collection and data visualization to support the management of individual patients at the point of care and patient populations within the organization.
This is a lofty and ambitious 10-year goal for HIT. The 10-Year Vision document is a rally point to coordinate this effort across the broad stakeholder group from patients to providers to vendors to payers. The transformation of HIT will be a national effort from sea to shining sea!
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