The federally chartered Health IT Policy Committee heard last week from its Strategic Plan Workgroup, which delivered advice to the Office of the National Coordinator for Health Information Technology for an annual update to the Federal Health IT Strategic Plan.
Health IT panel gets an earful on plan
At a full-committee meeting May 19, the Health IT Policy Committee took under advisement the work group's recommendations to make several tweaks to the plan. ONC head David Blumenthal said a final vote on the recommendations could come at the policy committee's next meeting, scheduled for June 25. The Health IT Policy Committee was created under the American Recovery and Reinvestment Act of 2009 to advise the ONC on IT policy issues.
One member of the policy committee found the language of the report to be incomprehensible to a lay audience. Another member complained that it lacked specifics. Others said that the national plan needs constraints on its scope.
Under the ARRA, also known as the stimulus law, HHS must submit to Congress by Nov. 1 each year an annual operating budget for the ONC showing how its expenditures are aligned with “the specific objectives, milestones and metrics” of the national strategic plan.
Health IT Policy Committee member Neil Calman is a physician and president and CEO of the Institute for Family Health, a New York collaborative that provides healthcare and healthcare education. Calman didn't serve on the strategic plan work group, so he approached its report with fresh eyes.
“It's thick,” Calman said. “It reads to me to be very academic, and … given all of the work we've been doing trying to make things publicly accessible, this doesn't feel very accessible to me. It doesn't feel to me like people other than those of us inside the computer system could really digest this and understand what it means to them.”
Calman suggested that the work group write two reports, one for the ONC and one a “public, translated version that makes it easy for people like me who haven't been involved in the nine meetings to just be able to pick it up and understand what it is we're trying to do in more simple terms.”
Work group member and Health IT Policy Committee Vice Chairman Paul Tang, also a physician and the chief medical information officer of the Palo Alto (Calif.) Medical Foundation, said drafters tried to make the report more approachable in its preamble but added the target audience for the report was the ONC, not the general public.
The report does include a recommendation that the ONC develop a communication strategy to tell members of the public “what are we talking about, how would this benefit you and what would you need to know for this to benefit us,” Tang said.
Health IT Policy Committee member Judith Faulkner, CEO of Epic Systems Corp., Verona, Wis., a developer of clinical IT systems for hospitals and group practices, said there is a danger that the plan is “morphing a little bit into committee, government control of the development of EHRs.”
Faulkner said she was particularly concerned about a section covering recommendations on the functionality and utility of electronic health-record systems.
“If the functionality of where EHRs go is going to be confined through this process here, I get really worried it won't be as good as leaving it to the open market to define functionality,” she said.
Developers benefit from feedback from “thousands and thousands” of users, Faulkner said. Relying instead on a government committee to get it right “leads us to a dangerous thing,” she said.
In contrast to Faulkner's complaint that the recommendations might be too specific, committee member Marc Probst said he thought the plan might not be specific enough. Probst is the chief information officer of Intermountain Healthcare in Salt Lake City.
“Early on when I read this, some of the early drafts, I came back with some comments, because I didn't really understand how it impacted me, not as a member of the HIT Policy Committee, but as a CIO, someone actually trying to implement some of these products,” Probst said. “And we had good discussion that this is really for ONC and focused on that direction. But the question I have, then, what's next with this? Because I do think it's probably from the office, from Blumenthal that people are looking for some guidance, and if we don't create those bounds, I think we do get into what Judy's talking about.
“There are certain things I'm looking for from someone, I don't know if it's from the Office of the National Coordinator or not, but there are very specific items that aren't addressed in this,” Probst said. “Nor do I see the plan to where they will be addressed, things like consent on a national level for” health information exchange.
In reply, Blumenthal stated: “What a strategic plan will do, we hope will do, is give us some guardrails and directions for our policy development and our implementation choices. So, I think from the standpoint of the ONC, this is a very valuable set of advisory documents that we can build on in our own internal work that will speed along our internal process of meeting the legislative requirement to have a plan and developing a plan that actually is useful.”
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