An update on ONCHITs national healthcare agenda
An update regarding the latest activities of the Office of the National Coordinator for Health Information Technology (ONCHIT), or programs it is associated with, was given to attendees of the 7th Annual Health IT Trends & Marketing 2006 Conference this week in Cambridge, MA. Ever since President Bush made a call in 2004 for EHRs to be available within 10 years for each American, the US Department of Health and Human Services (of which ONCHIT is a part) has had the goal of creating “health information that follows the consumer,” said Vish Sankaran, acting program manager, Federal Health Architecture, ONCHIT. Core concerns and tactics have been rising healthcare costs, highlighting the benefits for consumers from health IT, as well as utilizing economic incentives, Sankaran added.

Other key elements of the organization’s work has been the harmonization of standards, certification of products, creating a network capable of carrying the information so, again, “the data follows the consumer,” resolving conflicts between state and federal law, and adoption of health IT through ways that are driven by what consumers want, said Sankaran. Reducing errors, plus workflow changes within the healthcare system, he indicated, also have been high priorities.

Moreover, the approach taken to bring the transformation to fruition is through a combination of infrastructure changes combined with technological breakthroughs in the community/industry to show consumers the benefits of the technology as the infrastructure is built so that eventually adoption is more willful, Sankaran said.
To accomplish this, in mid-summer 2005 the American Health Information Community (AHIC) was formed. Called “the Community” it is comprised of nine public sectors and eight private sectors to address many of the key elements for the hoped-for healthcare transformation. AHIC has thus far formed recommendations to achieve near term results in health IT, and other steps which Sankaran said are viewed as “the business driver” behind making this happen.
Other updates on the overall agenda included:

  • Standards harmonization: A Health IT Standards Panel will, by the end of this year, release initial standards available for implementation;
  • The Certification Commission for Health IT (CCHIT) on July 18th released the initial EHR certifications. Next, Sankaran said, an inpatient EHR evaluation will be done by 2008, followed by Nationwide Health Information Network (NHIN) services criteria in 2008). Additionally, work is being done to more clearly define PHRs (Personal Health Records), and that will be done in early 2007;
  • NHIN – which in the process of fostering widely available services that aid the exchange of health information – involves four groups of healthcare and health IT organizations to develop internet-based NHIN network prototypes. The prototypes will demo interoperable networks in real-world healthcare environments. The project will make “a set of services available so that information can flow” more easily between healthcare facilities, Sankaran said, making it easier for information to be exchanged from point A to point B. These services would be available commercially. Overall, NHIN hopes to deliver the following components: practices and policies, standards, and certification all coordinated through the same architecture. In the end, NHIN will be but a “part of the solution but it is not the solution,” Sankaran said, and will take some time. This year they will take an initial step, but a full realization is years away at least; and
  • On the matter of privacy and security, Sankaran said that at ONCHIT “we strongly believe technology can provide greater protection than paper.” He said that because technology is able to provide auditing of data access, and is able to secure it via technological means, it is safer. Steps for healthcare to improve security and privacy include the adoption of policies beyond HIPAA, security implementation across healthcare organizations, and looking at differences between state laws.
Generally speaking, Sankaran said, the transformation of federal health IT will require a system that includes a Federal health IT environment that is interoperable with the private sector. He said that it is now understood that there is “a need for interoperability between the Federal government and the private sector” whereas before the original idea was for the system to be interoperable only on the Federal level.   

Since this process began, the transformation process has undergone some revision and new goals have been identified, including to further educate healthcare professionals, the interconnection of healthcare, and developing personalized health management.