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ONC's Five-Fold Federal Health IT Plan Looks Beyond EHRs

December 8, 2014
by Gabriel Perna
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Karen DeSalvo, M.D.
The Office of the National Coordinator for Health IT (ONC) released a five-fold federal health IT strategic plan, which focuses on widespread health data sharing and looks beyond adoption of electronic health record (EHR) systems. 
The ONC's five-fold plan does include the expansion of health IT adoption, particularly in the long-term care sector, but it also features the advancement of an interoperable infrastructure, the strengthening of the healthcare delivery system, the advancement of well-being of individuals and communities, and the advancement of scientific research. The first two, expansion of health IT adoption and advancement of interoperable infrastructure, are the top priorities, says ONC. All of them require some kind of interoperability push. 
On a call announcing the plan, Karen DeSalvo, M.D., the National Coordinator for Health IT, confirmed that there was a "big push for interoperability" with this latest plan. 
In particular, the plan, which covers 2015-2020, says ONC is looking to establish standards and guidance around data sharing between providers as well as providers and payers. On the call, the ONC's Seth Pazinski director at the office of planning evaluation, and analysis, says it represents a broadening focus representing different perspectives. "We're representing an array of regulators, purchasers/payers, and providers in this plan," he said, noting that 35 agencies contributed. 
The interoperability guidance isn't focused solely around information sharing with traditional systems, even though that's a significant part. There is also a push by ONC to advance standards for device to health IT products sharing. Also included is a section that seeks to protects patient data, while still advancing interoperability.
In the plan, the ONC reveals that expansion of EHR adoption needs to come from post-acute and long-term sectors. Furthermore, ONC says there needs to be a push to advance adoption of non-EHR health IT technologies such as mobile health (mHealth) applications and telehealth. 
Goal three--strengthening of the healthcare delivery system--is all about population health management. Pazinski said this includes improving access and coordination of care, which would mean using and integrating mHealth and telehealth for new care delivery models. Also included in this goal is the use of health IT systems to help clinicians with decision support and measuring clinical quality. 
On the theme of a broader focus, goal four is about data exchange among community stakeholders and public health entities. This includes, Pazinski said, inclusion of patient-generated health data, from personal devices such as a FitBit, into a patient's longitudinal record. It also includes integration into public health agencies for disease tracking. 
The fifth and final goal of the federal health IT plan is the advancement of scientific research and knowledge. This part of the plan includes an increased support of secure open-dataset releases for research purposes and the funding of research collaboratives. It also includes the funding of health IT product development and analyzing how health IT systems can improve outcomes and lower costs. 
ONC is taking public comment on the plan, which ends in two months on Feb. 6, 2015. The plan is a sequel to the first strategic outline from ONC, which covered 2011-2015. The latest plan comes at a time when the meaningful use incentive program derived from the Health Information Technology for Clinical and Economic Health (HITECH) Act is under fire from various industry stakeholders. With this latest plan, ONC appears to be looking beyond meaningful use  as soon as next year.