# Presentation: 308214

## American Health 

**A****merican ****H****ealth **
**I****nformation ****C****ommunity**
**Looking Forward:**
**Goals, Objectives, and Strategies**

## Strategic Framework

- Original Strategic Framework was released in July of 2004
- Articulated 4 goals and 12 strategies
- Vetted, discussed, and refined goals and strategies over the last two years to produce the updated strategic framework
- Reflects market based orientation
- Will be used to develop internal performance measures
- Communication vehicle with public and private partners

## Each Strategy Fits into One of Three Categories:

- Strategy has been initiated and specific actions are being taken
- Strategy is under active consideration and requires further discussion
- Strategy is for future discussion

## 10 Initiated Strategies       

**Goal 1: Inform Health Care Professionals**
- 	Strategy 1.1.1: Simplify health information access and communication among clinicians
- EHR Workgroup is focusing on access to needed clinical information
- 	Strategy 1.2.3: Lower risk of EHR adoption
- CCHIT Contract
- CMS DOQ-IT Initiative

## 10 Initiated Strategies

**Goal 2: Interconnect Health Care**
**	**
**	****Strategy 2.1.1: Establish well-defined health information standards**
- HITSP contract
- CCHIT contract
**	****Strategy 2.1.2: Ensure federal agency compliance with health information standards**
- FHA
- NIST
**	****Strategy 2.1.3: Exercise federal leadership in health information standards adoption**
- Workgroup’s recommendations
**	****Strategy 2.3.1:  Support the development and implementation of appropriate privacy and security policies, practices, and standards for electronic health information exchange**
- HISPC contract
- Workgroup recommendation to create a privacy and security subgroup
- HHS Policy Council

## 10 Initiated Strategies

**Goal 3: Personalize Health Management**
**	****Strategy 3.1.2:  Expand access to personal health management information and tools**
- Consumer Empowerment Workgroup recommendations
**	****Strategy 3.2.1:  Promote adoption of remote monitoring technology for communication between providers and patients**
- Chronic Care Workgroup recommendations	*	*
**Goal 4: Improve Population Health**
**	****Strategy 4.1.1:  Enable simultaneous flow of clinical care data to and among local, state, and Federal biosurveillance programs**
- Biosurveillance Workgroup recommendations
**	****Strategy 4.4.1:  Foster the availability of field EHRs to clinicians responding to disasters**
- Gulf Coast Digital Health Information Recovery Contract
- Rapid response EHR initiative

## 6 Strategies for Active Consideration

**Goal 1: Inform Health Care Professionals****	**
**	****Objective 1.2: Low Cost and Low Risk EHRs**
- 		**Strategy 1.2.1: Foster economic collaboration for EHR ****	****adoption**
*	**	**	*
*	**	**Hospitals, public health agencies and health **	**	**	**plans are interested in supporting physician **	**	**	**adoption of EHRs.  Yet, they face legal and **	**	**	**practical barriers to this type of collaboration.  **	**	**Policies that allow such collaboration when not **	**	**contrary to public interest would increase health **	**	**information technology uptake.*

## 6 Strategies for Active Consideration

**Goal 1: Inform Health Care Professionals****	**
- 	Objective 1.2: Low Cost and Low Risk EHRs
- 		**Strategy 1.2.2: Lower total cost of EHR purchase and ****	****implementation**
- 		*	*
*	**	**The costs of EHRs are high because a large amount **	**	**is spent on custom integration and accessing non-**	**	**standard information systems.  Also, the cost of **	**	**consultants, training, and implementation of these **	**	**specialized systems is high.  In addition to allowing **	**	**disparate parties to collaborate in installing EHRs, **	**	**efforts that lower the total cost of ownership will **	**	**enable many providers to use these tools. *

## 6 Strategies for Active Consideration

**Goal 2: Interconnect Health Care**
**	****Objective 2.2: Sustainable Electronic Health Information Exchange**
**	****	****Strategy 2.2.1: Stimulate private investment to develop ****	****the capability for efficient sharing of health information**
*The United States lacks the capacity for widespread and low cost health information sharing.  There is nothing in health care similar to the carriers that operate and compete in telephony or broadband.  To develop this capability in health care, a common technical architecture and substantial private sector investment is required.  These will together create supply side entry of offerings that will in turn allow more hospitals and physicians to access these tools. *

## 6 Strategies for Active Consideration

**Goal 2: Interconnect Health Care**
**	**
**	****Objective 2.2: Sustainable Electronic Health Information Exchange**
**	**
**	****	****Strategy 2.2.4: Support state and local governments and ****	****organizations to foster electronic health information ****	****exchange**
***	******	****Health care continues to be delivered locally and **	**regionally, and it is difficult for a top-down federal solution to **	**meet the needs of America’s diverse communities.  Many **	**states are developing strategies to foster health information **	**exchange, but local and regional efforts are also occurring as **	**well.  States have unique laws that affect privacy and security, **	**licensure, practice of medicine, insurance, liability, and have a **	**natural interest in improving health care for their citizens.  **	**	**Therefore, the states are the natural units for health **	**information exchange customization, and should be **	**supported and guided in this new role. *

## 6 Strategies for Active Consideration

**Goal 3: Personalize Health Management**
**	****Objective 3.1: Consumer Use of Personal Health Information**
**	****Strategy 3.1.1:  Establish value of personal health records, including consumer trust**
- 	*Personal health records (PHRs) are in the early stage of development, and no standard exists today to ensure that they meet a minimum set of requirements.  Additionally, PHRs today are generally not linked to the clinical information within EHRs, requiring extensive manual data entry and knowledge of particular details of medical information.  Although PHRs have the capability to give consumers better control over their care, consumers have no history from which to assess whether they should place their trust in PHRs. *

## 6 Strategies for Active Consideration 	

**Goal 4: Improve Population Health**
**	****Objective 4.2: Efficient Collection of Quality Information**
- 	**Strategy 4.2.1  Develop patient centric quality measures based on clinically relevant information available from interoperable longitudinal electronic health records**
**	****	**
*	**Much of quality measurement is currently provider focused – to assess performance of individual providers on a limited number of metrics.  Most of health care dollars, however, are spent on patients whose care spans multiple providers and settings.  As interoperable health information becomes available, there will be the ability to assess care at the patient-level across the continuum of care.  This will allow tremendous opportunity for systemic improvement in our health care delivery system, supported by more informed public policy and decisions. *

## 16 Strategies for Future Discussion 		

**Goal 1: Inform Health Care Professionals**
**	**
**	****Strategy 1.1.2: **Increase support for clinicians to use EHRs
**	**
**	****Strategy 1.3.1: **Increase investment in sources of evidence based knowledge
**	**
**	****Strategy 1.3.2: **Increase investment in tools that can access and integrate evidence based knowledge in the clinical setting
**	**
**	****Strategy 1.3.3: **Establish mechanisms which will allow clinicians to empirically access information and other patient characteristics that can better inform their clinical decisions
**	****Strategy 1.4.1: **Ensure low-cost EHRs for clinicians in underserved areas
**	****Strategy 1.4.2: **Support adoption and implementation by disadvantaged providers

## 16 Strategies for Future Discussion

**Goal 2: Interconnect Health Care**
**	**
**	****Strategy 2.2.2: **Use government payers and purchasers to foster interoperable electronic health information exchange
**	****Strategy 2.2.3: **Adapt federal agency health data collection and delivery to NHIN solutions
**	**
**	****Strategy 2.3.2:  **Develop and support policies to protect against discrimination from health information
**Goal 3: Personalize Health Management**
**	****Strategy 3.3.1:  **Promote consumer understanding and provider use of personal genomics for prevention and treatment of hereditary conditions
**	****Strategy 3.3.2 **Promote multi-cultural information support

## 16 Strategies for Future Discussion

**Goal 4: Improve Population Health**
- 	**Strategy 4.1.2:**  Ensure that the nationwide health information network supports population health reporting and management
- 	**Strategy 4.2.2:**  Ensure adoption of uniform performance measures by health care stakeholders
- 	**Strategy 4.2.3:**  Establish standardized approach to centralized electronic data capture and reporting of performance information
- 	**Strategy 4.4.2:**  Improve coordination of health information flow during disasters and crises
- 	**Strategy 4.4.3:**  Support management of health emergencies