Fact Sheet
HHS Fact Sheet--HIT Report At-A-Glance"The Decade of Health Information Technology: Delivering Consumer-centric and Information-Rich Health Care" A Framework for Strategic Action Overview: Today HHS Secretary Tommy G. Thompson released the first outline of a 10-year plan to build a national electronic health information infrastructure in the United States. The report, "The Decade of Health Information Technology: Delivering Consumer-centric and Information-Rich Health Care," lays out the broad steps needed to achieve always-current, always-available electronic health records (EHR) for Americans. This responds to the call by President Bush this year to achieve EHRs for most Americans within a decade. The report identifies goals and action areas, as well as a broad sequence needed to achieve the goals, with joint private/public cooperation and leadership. The report was prepared by National Coordinator for Health Information Technology David J. Brailer, M.D., Ph.D., appointed in May to the new position created by the President in an April executive order. The executive order mandated today's report, and also mandated additional related reports by the Department of Veterans Affairs, Department of Defense and the Office of Personnel Management, which were also being released today. Today's report was issued at the Secretarial Summit on Health Information Technology, convened in Washington D.C. to bring together the nation's top leaders in information technology and health care. At the Summit, Secretary Thompson also announced several new immediate actions to help accelerate health information technology adoption. The Promise of Health Information Technology Use of modern information technology has the potential to transform the delivery of health care in America for the better -- and to do so without heavy-handed regulation or upheaval in the health care sector:
Why Isn't Modern Health Information Technology Already in Place? The benefits of information technology have taken hold all around us, from banks to grocery stores. But today's report states: "The innovation that has made American medical care the world's best has not been applied to its health information systems." Hospitals' use of EHRs in 2002 was reported at 13 percent; and for physicians' practices, 14 percent to a possible high of 28 percent. Among the reasons for the slow adoption:
Framework for Action: Goals and Strategies Secretary Thompson said today's report launches the Decade of Health Information Technology, an initiative with joint public-private leadership to obtain the benefits of health information technology for Americans. The report says that "the federal government will provide a vision and a strategic direction for a national interoperable health care system, but will rely on a competitive technology industry, privately operated support services, and shared investments �." The private sector must develop the market institutions to deliver the products and services. It can best ensure that health information technology products are implemented in ways that meet the varying needs of American health care across settings, cultures, and geographies. And only it can continue constant innovation and ensure that products are delivered on an affordable basis. The report identifies four major collaborative goals. With these goals are 12 strategies for advancing and focusing future efforts: Goal 1: Inform Clinical Practice. This goal centers largely around efforts to bring EHRs directly into clinical practice. Three strategies for realizing this goal are: Strategy 1. Provide incentives for EHR adoption. The transition to safe, more consumer-friendly and regionally integrated care delivery will require shared investments in information tools and changes to current clinical practice. Strategy 2. Reduce risk of EHR investment. Clinicians who purchase EHRs and who attempt to change their clinical practices and office operations face a variety of risks that make this decision unduly challenging. Low-cost support systems that reduce risk, failure, and partial use of EHRs are needed. Strategy 3. Promote EHR diffusion in rural and underserved areas. Practices and hospitals in rural and other underserved areas lag in EHR adoption. Technology transfer and other support efforts are needed to ensure widespread adoption.
Goal 2: Interconnect Clinicians. Interconnecting clinicians will allow information to be portable and to move with consumers from one point of care to another. This will require an interoperable infrastructure to help clinicians get access to critical health care information when their clinical and/or treatment decisions are being made. Three strategies for realizing this goal are: Strategy 1. Regional collaborations. Local oversight of health information exchange that reflects the needs and goals of a population should be developed. Strategy 2. Develop a national health information network. A set of common intercommunication tools such as mobile authentication, Web services architecture, and security technologies are needed to support data movement that is inexpensive and secure. A national health information network that can provide low-cost and secure data movement is needed, along with a public-private oversight or management function to ensure adherence to public policy objectives. Strategy 3. Coordinate federal health information systems. There is a need for federal health information systems to be interoperable and to exchange data so that federal care delivery, reimbursement, and oversight are more efficient and cost-effective. Federal health information systems will be interoperable and consistent with the national health information network. Goal 3: Personalize Care. Consumer-centric information helps individuals manage their own wellness and assists with their personal health care decisions. Three strategies for realizing this goal are: Strategy 1. Encourage use of Personal Health Records. Consumers are increasingly seeking information about their care as a means of getting better control over their health care experience, and PHRs that provide customized facts and guidance to them are needed. Strategy 2. Enhance informed consumer choice. Consumers should have the ability to select clinicians and institutions based on what they value and the information to guide their choice, including the quality of care providers deliver. Strategy 3. Promote use of telehealth systems. The use of telehealth -- remote communication technologies -- can provide access to health services for consumers and clinicians in rural and underserved areas. Goal 4: Improve Population Health. Population health improvement envisions improved capacity for public health monitoring, quality of care measurement and bringing research advances more quickly into medical practice. Three strategies for realizing this goal are: Strategy 1. Unify public health surveillance architectures. An interoperable public health surveillance system is needed that will allow exchange of information, consistent with privacy laws, to better protect against disease. Strategy 2. Streamline quality and health status monitoring. Many different state and local organizations collect subsets of data for specific purposes and use it in different ways. A streamlined quality-monitoring infrastructure that will allow a complete look at quality and other issues in real-time and at the point of care is needed. Strategy 3. Accelerate research and dissemination of evidence. Information tools are needed that can accelerate scientific discoveries and their translation into clinically useful products, applications, and knowledge. EHR Incentive Options to Be Reviewed Looking in particular at EHRs and incentive options, the report says HHS will examine many potential policy options for incentivizing EHR adoption. The report says options to be reviewed include:
In order to better assess such options, Secretary Thompson is convening a Health Information Technology Leadership Panel, consisting of executives and leaders. This panel will assess costs and benefits and will consider immediate steps for both the public and private sector. The Health Information Technology Leadership Panel will deliver a report to the Secretary by this fall. In addition, HHS and the Office of Personnel Management are participating in the recently formed National Alliance for Health Care Information Technology Advancement. The Alliance is comprised of purchasers and payers representing almost 200 million covered persons. It will work toward identifying financial and non-financial incentives. HHS will work closely with the Alliance during the next 90 days to identify specific strategic actions to meet these goals. Key Actions Secretary Thompson announced a range of actions underway or soon to be launched, which will advance the strategic elements of the “Framework:” Establishing a Health Information Technology Leadership Panel to evaluate the urgency of investments and recommend immediate actions -- Secretary Thompson will appoint the panel of executives and leaders to assess the costs and benefits of health information technology to industry and society, and develop options for immediate steps by both the public and private sector, based on their individual business experience. The Health Information Technology Leadership Panel will deliver a report on these options to the Secretary no later than fall 2004. Private sector certification of health information technology products -- EHRs and even specific components such as decision support software are unique among clinical tools in that they do not need to meet minimal standards to be used to deliver care. To increase uptake of EHRs and reduce the risk of product implementation failure, the federal government is exploring ways to work with the private sector to develop minimal product standards for EHR functionality, interoperability, and security. A private sector ambulatory EHR certification task force is determining the feasibility of certification of EHR products based on functionality, security, and interoperability. Funding community health information exchange demonstrations -- HHS’ Health Resources and Services Administration, with the Foundation for eHealth Initiative, announced $2.3 million in contracts to support the Connecting Communities for Better Health Program. The program is providing seed funds to implement health information exchanges, including the formation of regional health information organizations. Planning the formation of a private interoperability consortium -- To begin the process of movement toward a national health information network, HHS will issue a Request for Information (RFI) this summer inviting responses describing the requirements for private sector consortia that would form to plan, develop, and operate a health information network. The role that HHS could play in facilitating the work of the consortium and assisting in identifying the services that the consortium would provide will be explored, including the standards to which the health information network would adhere in order to ensure that public policy goals are executed and that rapid adoption of interoperable EHRs is advanced. Requiring standards to facilitate electronic prescribing -- CMS is accelerating publication of a regulation laying out the first set of widely adopted e-prescribing standards in preparation for the implementation of the new Medicare drug benefit in 2006. When the final standards are adopted, Medicare Prescription Drug Plan (PDP) Sponsors will be required to offer e-prescribing, which will significantly drive adoption across the United States. The proposed regulation will be published by CMS this year. Establishing a Medicare beneficiary portal -- CMS will develop a Medicare Beneficiary Portal, an immediate step in improving consumer access to personal and customized health information, providing secure health information via the Internet. The portal will enable authorized beneficiaries to have access to their Medicare information online or by calling 1-800-MEDICARE. Initially the portal will provide access to fee-for-service claims information, which includes claims type, dates of service, and procedures. The pilot test for the portal will be conducted in Indiana, beginning this year. In the near term, CMS plans to expand the portal to include prevention information in the form of reminders to beneficiaries to schedule their Medicare-covered preventive health care services. CMS also plans to work toward providing additional electronic health information tools to beneficiaries for their use in improving their health. Commitment to standards -- A key component of progress in interoperable health information is the development of interoperability standards and policies. HHS, DoD, and VA have endorsed 20 sets of standards to make it easier for information to be shared across agencies and to serve as a model for the private sector. Additionally, the Public Health Information Network (PHIN) and the National Electronic Disease Surveillance System (NEDSS), under the leadership of the Centers for Disease Control and Prevention (CDC), have made progress in development of shared data models, data standards, and controlled vocabularies for electronic laboratory reporting and health information exchange. With HHS support, Health Level 7 (HL7) has also created a functional model and standards for the EHR. ### Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news. Last Revised: July 21, 2004 |