On January 15, 2020 the U.S. Department of Health and Human Services (HHS) released the draft 2020-2025 Federal Health IT Strategic Plan (“strategic plan”) for public comments. Developed by the HHS Office for the National Coordinator for Health Information Technology (ONC) in collaboration with more than 25 federal organizations, the strategic plan outlines health IT goals aimed at ensuring individual access to electronic health information and facilitating consumer shopping for healthcare providers and managing their care. Citing advances in technology and the shift in focus to value-based care, the strategic plan emphasizes interoperability and patients’ right to access and manage their health data.
The draft strategic plan outlines four broad goals for the use of health IT:
- Promote health and wellness;
- Enhance the delivery and experience of care;
- Build a secure, data-driven ecosystem to accelerate research and innovation; and
- Connect healthcare and health data through an interoperable health IT infrastructure.
HHS states that the strategic plan is intended to serve as a “roadmap for federal agencies” and also to “drive private sector alignment.” The strategic plan is broad in scope, and includes overarching strategies that are intended to apply to many federal departments, agencies and offices. ONC officials characterized the draft strategic plan as “deliberately outcomes-driven” and “focused on meeting the needs of individuals, caregivers, populations, healthcare providers, payers, researchers, developers and innovators.” Through implementation of the strategic plan, ONC seeks to identify current challenges in health IT and identify strategies for addressing these issues.
Promote Health and Wellness
The first goal in the strategic plan is to use health IT to empower patients and facilitate the improvement of health and wellness through electronic health information. In furtherance of this goal, the strategic plan focuses on improving individual access to health information by promoting increased access and portability of information through application programming interfaces (APIs) and user-focused technologies such as smartphones. The strategic plan also identifies the potential use of health IT to address existing and potential public health issues. A strengthened health IT infrastructure would allow for integration and coordination between agencies in capturing and understanding individual and community needs.
Enhance the Delivery and Experience of Care
The second goal aims to improve health care delivery and quality through the use of health IT, looking at opportunities to improve health systems using advanced technologies such as machine learning. By providing more price transparency for healthcare services and facilitating patients’ ability to shop for care based on value, health IT may encourage competition and drive down costs and prices. In addition, more streamlined and efficient health IT systems would reduce regulatory and administrative burdens on providers and leave more time for providers to interact with patients.
Build a Secure, Data-Driven Ecosystem to Accelerate Research and Innovation
The third goal seeks to develop policies promoting the use of secure, standards-based APIs to provide access to data in EHRs, empowering all parties to contribute to both individualized care and population-level improvement and research. A vast amount of health data is generated every day, and this growing volume of data is vital to research efforts. However, this data also generates privacy and data security concerns. By developing efficient and safe ways to use this data, health IT would contribute greatly to healthcare innovation.
Connect Healthcare and Health Data through an Interoperable Health IT Infrastructure
With most health data stored in EHRs, interoperability has become an increasingly pressing issue. Patients and providers struggle with the inability to obtain complete and accurate health records, as different health data systems are incapable of communicating with each other or transmitting data. The HHS Interoperability and Patient Access Proposed Rule issued on February 11, 2019 introduced new policies with many of the same objectives listed in the ONC strategic plan. In addition to promoting the adoption of APIs, the proposed rule contemplated that patient electronic access to EHRs be made available at no cost. The 21st Century Cures Act prohibited information blocking, however, the current environment creates incentives for actors to limit availability for “access, exchange, and use by individuals and healthcare providers.” The fourth goal of the strategic plan seeks to enable more seamless and secure access to EHRs by addressing information blocking and working with “developers, providers, payers and state and federal entities to eliminate unnecessarily restrictive data sharing practices.” With increased information sharing, privacy and security measures must be integrated into the design and use of health IT systems to prevent misuse of patient data. Improved communications infrastructures would also help address the disparity in health IT access and capabilities in rural and underserved areas.
While the majority of healthcare providers now use EHRs, the data is often not readily accessible to patients, caregivers, and other healthcare providers. With a focus on interoperability, the strategic plan attempts a more targeted approach to improving the patient experience and the operations and abilities of the health IT infrastructure. While the goals and objectives described in the strategic plan are relatively broad, they provide a common foundation for many different federal departments, agencies and offices to begin implementing health IT initiatives and strategies. The final 2020-2025 strategic plan is intended to be used by federal agencies and officials to drive private sector alignment, prioritize resources, and coordinate efforts across agencies. ONC will provide updates on progress in its annual report to Congress on health IT adoption and use.
ONC is accepting public comments on the draft until 11:59 PM EST on March 18, 2020. Public comments may be submitted here.