ONC's National Consumer e-Health Action Plan
In a recent Health Affairs article, ONC described its national action plan to support consumer engagement via e-heath as being driven by the "Three As:" Access, Action and Attitudes.
Access
The first objective is to increase access to health information and to help ensure that consumers are active participants in the electronic exchange of their health information. Under existing law, consumers already have certain legal rights to review and obtain their medical records from health care providers and health plans. As health care providers switch from paper to electronic records, ONC is working to ensure that consumers have access to this information electronically and in ways that are compatible with emerging consumer health technologies, such as mobile health applications. Two ways that ONC has been increasing access to health information are the Medicare and Medicaid Electronic Health Record Incentive Program and the Blue Button Initiative.
Medicare and Medicaid EHR Incentive Programs
To achieve Stage 2 meaningful use and receive financial incentives under the EHR incentive programs, participating health care providers must increase their efforts to share data electronically with patients. For example, eligible professionals must provide patients the ability to view online, download and transmit their health information within four business days of the information being available to the eligible professional. Eligible hospitals must also provide patients the ability to view online, download and transmit information about a hospital admission. Among other related requirements, eligible professionals must also provide clinical summaries for patients for each office visit and use secure electronic messaging to communicate with patients regarding relevant health information.
Blue Button Initiative
Blue Button is a Web tool consumers can use to view and download their personal health information. The Department of Veterans Affairs uses Blue Button to make claims and clinical information available to veterans in a text file so that they may use the information to better coordinate their own care. CMS makes claims information available to Medicare beneficiaries in the same fashion. Other federal agencies, as well as private health plans such as United HealthCare and Aetna, have also adopted Blue Button as a way to make health care data available to their beneficiaries in a printable, downloadable format.
To further catalyze access to health information, ONC created the "Blue Button Pledge." A wide variety of organizations participate in the Pledge Program, including AARP and Kaiser Permanente. Participants make pledges ranging from directly providing electronic access to health data, to developing tools that make it useful, to promoting a public shift in awareness of and attitudes about consumer engagement in health.
Action
The second objective in the national e-Health action plan is to enable consumers to take action based on their health information by encouraging the development of tools and services that help make electronic health information useful. ONC notes that, by itself, access to health information may provide benefits for consumers who want to take greater control over their personal health. But in combination with new tools and services, this access presents numerous opportunities to understand and use information to help make better health choices.
An example of ONC's efforts to enable consumers to take action based on their health information is the Automate Blue Button Initiative. ONC is working to automate Blue Button by developing standards and specifications that allow consumers not only to download their health information to their personal computer, but also to privately and securely automate the sending of that data from their health care providers to their personal health records, email accounts, health apps or other preferred holding places.
ONC also issues "Innovation Challenges," which are public contests for technology developers to create tools related to a particular need. A current example is the Apps4TotsHealth Challenge, which is a call for innovators to make use of the Healthdata.gov data API and integrate the TXT4Tots message library into a new or existing platform. TXT4Tots is a library of short, evidence-based messages focused on nutrition and physical activity. The library is targeted to parents and caregivers of children ages one to five.
Attitudes
The third objective is to shift attitudes so that consumers think and act as partners in their care with the support of e-health tools. ONC notes that sometimes consumers encounter barriers when trying to take a more active role in their care. In many cases, consumers may lack the information they need to make informed decisions, or not have the tools they need to make sense of the information they have. Enabling consumers to play a more active role in their care and creating stronger care partnerships will require a shift in attitudes by all involved.
An example of how ONC has been working to shift attitudes is its launch of HealthIT.gov to serve as a "one-stop shop" for consumers to learn about health IT tools and to hear stories about how health IT and greater engagement has benefitted consumers. The site offers a toolkit for organizations that want to educate their employees, customers or others about health IT. ONC also has run a series of contests encouraging consumers to create videos telling their stories about how health IT improved their health and increased involvement in their own care.
National eHealth Collaborative Patient Engagement Framework
Complementing ONC's efforts, the National eHealth Collaborative developed the Patient Engagement Framework, designed to help health care organizations develop engagement strategies using health IT. NeHC, established through a grant from ONC, is a public-private partnership focused on achieving health information interoperability through efforts like consumer e-health and others.
The Framework outlines several attributes of organizations that successfully engage and support patients in their care. It provides a series of phases to show the progression from a provider-centric care model to a patient-centered care model. The phases of the framework include "inform me," "engage me," "empower me," "partner with me" and "support my community." Within these phases, the framework builds on an organization's capabilities in areas such as information and way-finding, e-tools, forms and patient education, and patient access to their information.
Federal Strategic Plan Update
The Strategic Plan outlines goals and strategies for the nationwide shift to EHRs and electronic health information exchange, and for the creation and spread of new health information technologies. ONC published a final version of the Strategic Plan for 2011-2015 on Nov. 10, 2011.
Recognizing the continually evolving nature of the health care system, ONC updates the Strategic Plan as appropriate. To this end, ONC has partnered with researchers at Cornell University to provide "Planning Room," a website that makes it easy for stakeholders to offer their thoughts, experiences and suggestions on various parts of the Strategic Plan.
ONC is currently soliciting feedback on the consumer e-health-related portions of the Plan. In the Planning Room, ONC has set forth the following discrete topics for feedback from the public:
- Enabling information access;
- Identifying useful health information;
- Decreasing health disparities through health IT;
- Empowering consumer action;
- Patient generated health data;
- Supporting "personalized health care;"
- Shifting attitudes;
- Supporting "shared decision-making" through health IT;
- Supporting new health care delivery models; and
- Using health IT to enable research and inform practice.
Stakeholders do not have to submit formal comments; they need only to post a comment in the various threads, which can be read by all who visit the site. As of April 16, there were 40 comments on the topic of "patient-generated health data," for example, many of them discussing the benefits and challenges of incorporating such data into clinical care.
ONC is accepting feedback through May 9 on the consumer e-health-related portions of the Plan.
---
Autor(en)/Author(s): Helen R. Pfister and Susan R. Ingargiola
Quelle/Source: iHealthBeat, 22.04.2013
Bitte besuchen Sie/Please visit:
