A framework for strategic action: the report from HHS's secretarial summit on health information technology, cornerstones for electronic health care.

Abstract:

The National Health Information Infrastructure (NHII) conference this year was influenced heavily by the recent Federal initiatives to accelerate the adoption of information technology. Renamed the "Department of Health and Human Services Secretarial Summit on Health Information Technology: Cornerstones for Electronic Health Care", health care information technology stakeholders including clinicians, developers, informaticians, policy makers, thought leaders, and others gathered to praise and give feedback on the framework for strategic action: The Decade of Health Information Technology: Delivering Consumer-centric and Information. The progress report was generated by the newly established Office of the National Coordinator for Health Information Technology. Both the report and the new office were created in response to the April 27th Presidential Executive Order 13335 entitled, "Incentives for the Use of Health Information Technology and Establishing the Position of the National Health Information Technology Coordinator." The format of the meeting was familiar to previous NHII attendees with breakout sessions used to provide feedback to the Framework for Strategic Action. The final day of the conference presented the breakout session results to The National Committee on Vital and Health Statistics (NCVHS), a public advisory body to the Secretary of Health and Human Services.

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On April 27th of 2004, the Presidential Executive Order entitled, "Incentives for the Use of Health Information Technology and Establishing the Position of the National Health Information Technology Coordinator" rippled through the Informatics community. The Executive Order provides leadership for the development and implementation of a nationwide interoperable health information technology infrastructure and established the position of the National Health Information Technology Coordinator to be created and appointed by the Secretary of Health and Human Services (HHS). The appointee to this position is Dr. David Brailer MD, Ph.D., who was previously a Senior Fellow at the Health Technology Center in San Francisco, who served for ten years as Chairman and CEO of CareScience, Inc., and is an expert in regional and national data sharing projects.

The National Coordinator of Health Information Technology is responsible for developing a nationwide interoperable health information technology infrastructure that will allow the secured, authorized exchange of health information to guide medical decisions, to improve health care quality, improve efficiency in health care delivery, decrease errors, promote a more effective health IT marketplace, and improve the coordination of care and information among health care providers. Responsibilities of the Office are to develop, maintain and direct the implementation of a strategic plan to lead public and private health care sectors to implement interoperable health IT to reduce errors, improve quality and provide value. The Framework for Strategic Action, in response to the requirements of the Executive Order was delivered to the public at the July 21st 2004 Department of Health and Human Services Secretarial Summit on Health Information Technology: Cornerstones for Electronic Health Care. (http://www.whitehouse.gov/news/releases/2004/04/20040427_4.html).

The July 2004 Summit, held in Washington DC, was attended by over 1,500 individuals from constituencies that represented healthcare providers, public and private payers, consumers, and experts in IT. Reactions from these constituencies in the Reactor Panels were unanimously positive. In the Provider Reactor Panel for Clinical Leadership, Linda J. Stierle, MSN, RN, CNAA, BC, Chief Executive Officer, American Nurses Association spoke to the role of nurses as advocates for patients and the natural extension of nurses embracing technology to improve quality, decrease errors and reduce inefficiencies. In addition, Stierle noted that thousands of nurses already use IT everyday to achieve these goals.

The report "The Decade of Health Information Technology: Delivering Consumer-centric and Information-rich Health Care - A Framework for Strategic Action" outlines four goals that need to be pursued to achieve the improvements in health care (http://www.hhs.gov/onchit/framework/):

1. Inform Clinical Practice--This goal focuses primarily around bringing Electronic Health Records (EHR's) into clinical practice environments.

2. Interconnect Clinicians--This goal will support the development and implementation of an infrastructure that will interconnect clinicians with healthcare information and allow information to be portable and move with consumers from practice environment to practice environment.

3. Personalize Care--This goal will ensure the development of a consumer-centric infrastructure that will allow individuals to manage their own wellness and assist their health care decisions.

4. Improve Population Health--This goal will allow the use of timely and accurate health care information to detect and respond to trends in public health, more effectively evaluate quality, and accelerate and more effectively and efficiently disseminate, and implement scientific discoveries related to advancements in health care.

These goals are designed to facilitate alignment and cooperative effort by the various public and private sector participants who will accomplish the vision of nationwide interoperable health information through rapid and sustainable change. The Strategic Framework builds on several years of progress by the public and private sectors. Attention given to the issue of health care IT by HHS Secretary Thompson, other Federal agencies, and private sector groups resulted in the 2003 health care IT demonstration grants, FDA medication barcode rulings, Consolidated Health Informatics standards recommendations, the first National Health Information Infrastructure Conference and many other accomplishments. Private activities to promote health care IT have taken place in standards, provider, payer, professional associations and numerous other types of organizations. These efforts have laid the foundation for this Framework for Strategic Action and are a powerful start to achieving the goals outlined in the Framework.

The final day of the conference presented the breakout session results to The National Committee on Vital and Health Statistics (NCVHS), the public advisory body to the Secretary of Health and Human Services. Participants' complete testimony will be posted as public testimony on the NCVHS website. (http://www.ncvhs.hhs.gov/).

By Linda F. Fischetti RN MS and Jennie Harvell

Linda F Fischetti is the Health Informatics Architect for the Veterans Health Administration. Jennie Harvell is a Senior Policy Analyst at the Department of Health and Human Services.