The Office of the National Coordinator for Health Information Technology (ONC), a division of the U.S. Department of Health and Human Services, has released a plan to “coordinate the federal government’s health IT efforts, which seek to achieve nationwide implementation of an interoperable health IT infrastructure throughout both the public and private sector.”
Experts say the plan is poorly conceived and unlikely to be efficiently completed or implemented.
The “ONC-Coordinated Federal Health IT Strategic Plan 2008-2012” focuses on patient-centered health care and population health. Its stated goals are a transformation to higher quality, more cost-efficient care that better meets patients’ needs through technology such as electronic health information access and use and an increase in appropriate, authorized, and timely access and use of electronic health information to benefit public health, biomedical research, quality improvement, and emergency preparedness.
The result, according to Robert Kolodner, national coordinator for health information technology, would be a secure and interoperable health IT architecture that can facilitate “reliable data exchange, accelerate IT adoption, and foster collaborative governance.”
Kolodner added, “The plan provides an extensive documentation of the work completed by ONC and other federal partners over the past five years. It also establishes the next generation of health IT milestones to harness the power of information technology to help transform health and care in this country.”
‘Miserable Track Record’
Greg Scandlen, director of Consumers for Health Care Choices at The Heartland Institute, called the initiative “poorly conceived,” adding, “the federal government has a miserable track record when it comes to imposing large information systems, even within its own agencies.
“The idea that somehow the Department of Health and Human Services will be able to effectively mandate an optimal information system not only on federal agencies but the private sector as well is ludicrous,” Scandlen said.
“I have lost track of how many ‘Health IT’ initiatives I’ve seen coming out of the Department of Health and Human Services,” said John R. Graham, director of health care studies at the Pacific Research Institute. “Real, patient-centric health IT will come when patients command the resources spent on their health care, not by another executive order.”
Would Stop Progress
“Any system that is imposed today will be obsolete in five years,” Scandlen said. “Yet the federal government is woefully incapable of changing or eliminating outdated rules and regulations. So we will be stuck for all time with whatever they come up with today.”
Explosive growth in information technology and experimentation is already underway, Scandlen pointed out, with entrepreneurs and innovators across America rolling out new approaches, trying them out, refining them based on experience, and repeating the process. “We do not yet know what approach works best,” Scandlen said, “which is most user-friendly, most efficient, most informative, best at securing privacy.
“This is how innovation is supposed to work–trial and error repeated over and over until the optimal system emerges,” Scandlen concluded. “A federally imposed mandate will bring that to a screeching halt.”
Dr. Sanjit Bagchi ([email protected]) writes from India.
For more information …
“ONC-Coordinated Federal Health IT Strategic Plan: 2008-2012,” U.S. Department of Health and Human Services, June 3, 2008: http://www.heartland.org/article.cfm?artId=23494