The US Needs a New Improved National Health IT Strategy!

The US Government Accountability Office published the following on the 14^th February, 2008.

http://www.gao.gov/docsearch/abstract.php?rptno=GAO-08-499T

Health Information Technology: HHS Is Pursuing Efforts to Advance Nationwide Implementation, but Has Not Yet Completed a National Strategy

GAO-08-499T February 14, 2008

Highlights Page (PDF) Full Report (PDF, 13 pages) Accessible Text

Health information technology (IT) offers promise for improving patient safety and reducing inefficiencies. Given its role in providing health care in the United States, the federal government has been urged to take a leadership role to improve the quality and effectiveness of health care, including the adoption of IT. In April 2004, President Bush called for widespread adoption of interoperable electronic health records within 10 years and issued an executive order that established the position of the National Coordinator for Health Information Technology within the Department of Health and Human Services (HHS). The National Coordinator, appointed in May 2004, released a framework for strategic action two months later. In late 2005, HHS also awarded several contracts to address key areas of health IT. GAO has been reporting on the department's efforts toward nationwide implementation of health IT since 2005. In prior work, GAO recommended that HHS establish detailed plans and milestones for the development of a national health IT strategy and take steps to ensure that its plans are followed and milestones met. For this testimony, GAO was asked to describe HHS's efforts to advance the use of health IT. To do this, GAO reviewed prior reports and agency documents on the current status of relevant HHS activities.

HHS and the Office of the National Coordinator have been pursuing various activities in key areas associated with the President's goal for nationwide implementation of health IT. In 2005, the department established the American Health Information Community, a federal advisory committee, to help define the future direction of a national strategy for health IT and to make recommendations to the Secretary of Health and Human Services for implementing interoperable health IT. The community has made recommendations directed toward key areas of health IT, including the expansion of electronic health records, the identification of standards, the advancement of nationwide health information exchange, the protection of personal health information, and other related issues. Even though HHS is undertaking these various activities, it has not yet developed a national strategy that defines plans, milestones, and performance measures for reaching the President's goal of interoperable electronic health records by 2014. In 2006, the National Coordinator for Health Information Technology agreed with GAO's recommendation that HHS define such a strategy; however, the department has not yet done so. Without an integrated national strategy, HHS will be challenged to ensure that the outcomes of its various health IT initiatives effectively support the President's goal for widespread adoption of interoperable electronic health records.

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This document provided an invaluable summary of how US Federal health IT initiatives have progressed since the 2004 Presidential Executive Order which proposed interoperable Electronic Health Records for all by approximately 2014.

Essentially what has happened is that there was developed a high level strategy and this strategy led to a number of implementation streams around EHRs, Standards, Certification and Health Information Networking. Now all these parts need to be put together and an implementation plan to get it all done over the next five years is needed.

I for one can understand just what a huge task this will be at any level of detail – which seems to be what the GAO is asking for – and if this can be done and published by mid 2008 it will be quite a feat! I must say it is a trifle unfair for the GAO to be too critical given the progress in each of the main areas that has been made. Maybe if the Congress has provided the budget support ONCHIT requested over the last few years progress would have been more rapid.

David.