HITPC workgroups on strategic plan: More focus on people, outcomes

The Federal Strategic Health Plan requires a more person-centered framework with stronger linkages to achieving the triple aim. Moreover, some realignment is necessary so activities more clearly reflect its stated visions and principles, according to suggestions from two workgroups at the Health IT Policy Committee meeting on Feb. 10.

The strategic plan, released in December, contains five specific goals developed by 35 different federal partners and private stakeholders. These goals are: (1) expand adoption of health IT; (2) advance secure and interoperable health information; (3) strengthen healthcare delivery; (4) advance the health and wellbeing of individuals and communities; and (5) advance research, scientific knowledge and innovation.

In all, the plan aims to improve healthcare, individual, community and public health and advance research across the federal government and in collaboration with private industry, according to the Department of Health and Human Services.

However, on paper, “it felt like the framework focused more on data and less on the person at the center,” said Consumer Workgroup chair Christine Bechtel, who heads the Bechtel Health Advisory Group. “We need a fresh set of eyes to see what the consumer goals are in achieving the larger healthcare goals.”

To address this, her workgroup formally recommended adding an additional goal: building a culture of individual, provider and community partnerships to achieve shared person-centered health and healthcare goals. According to Bechtel, this means:

• Leveraging health IT so individuals, providers, community-based organizations and other patient supports will partner together to identify, align to and achieve health and care goals;
• ligning around shared person-centered goals for health and care will help the federal government and all healthcare stakeholders to align efforts in patient engagement, quality measurement, reporting and payment
• Health systems will be incentivized to continuously work with individuals to document, measure, refine, communicate and achieve objectives that are both meaningful to patients and achievable by the delivery system; and
• An umbrella goal for areas such as care planning, shared decision making, patient-generated health data, health literacy and communication, etc.

Drilling down a bit, Bechtel cited portal fatigue and data fragmentation as areas requiring consideration. There is a need to foster the ability to aggregate data from multiple sources and share seamlessly, she said. “We’re hearing from providers that consumers are not going online and accessing personal information. How may we promote using a gateway for the full and effective use of health information?”

Another area missing from the strategic plan is equity, she said. “We wanted to suggest that both health literacy and health IT literacy are important components of usability and equity.” More also is needed on social determinants of health, she said.

David Lanksy and Jennifer Covich, chair and co-chair of the Strategy and Innovation Workgroup, presented similar findings. “The learning health system, payment reform—all those things in the principle section—require infrastructure beyond what was laid out in the documents,” Covich said.

The workgroup also called for the plan to better speak to the diverse stakeholders and the public, and align better with other national planning activities and goals. To that end, it suggested making Goal 4, which touches on individual and population health, the primary goal—while aligning it with the National Quality Strategy, Healthy People 2020; and the HHS Disparities Action Plan.

The plan should be aligned with public health goals and outcomes, with federal agencies identifying which technologies and programs will support them.

“The whole perspective of collecting, sharing and using does seem to have roots in a data-focused world. We need a more dynamic learning system, a more robust feedback loop,” said Lanksy.