The ONC's early draft health IT plan is largely being seen as a right-on-target vision – but one accompanied by a strategy lacking in sufficient tactical detail.

"This is a good framework," says Brian Ahier, a health IT evangelist at Mid-Columbia Medical Center, outside of Portland, Oregon. Not without skepticism, Ahier continues, "it's well-written and hopefully going to be well-executed." 

The execution goals that ONC (Office of National Coordinator) outlined, however, are sparking early questions about the plan's practicability – both at the ONC's comments page and in interviews Government Health IT conducted. 

"It's ambitious to have all five goals for a 4-year strategy, especially since goals 2-5 are predicated on the adoption rates, and the success of HITECH," says Patrick Howard, HIT consultant at Webmenders consulting.

Piecing the puzzle

How will all the current mandates and health IT initiatives ever fit together?

That's a question that outgoing ONC director David Blumenthal explains he has heard many times during the last two years, in reference to the HITECH (Health Information Technology for Economic and Clinical Health) Act piece of the ARRA (American Recovery and Reinvestment Act), as well as the Affordable Care Act. Not to mention Meaningful Use specifically, ICD-10, HIPAA 5010.

Blumenthal's answer came in the draft Federal Health IT Strategic Plan 2011-2015, published late last week.

With the draft, the ONC hopes to guide the U.S. through what he describes as an "unprecedented opportunity to modernize the way care is delivered, and improve the health of all Americans."

Blumenthal explains in the plan's introduction that the vision is to create "a health system that uses information to empower individuals and to improve the health of the population." The very "lifeblood" of that intent, Blumenthal writes, is electronic health information.

[See also: HHS publishes strategy to improve national healthcare quality.]

As such, the framework comprises five goals: promote EHR adoption and information exchange; improve care and reduce costs to bolster population health; inspire confidence in health IT; empower individuals with IT to improve their health and the system; and enable rapid learning and technological advancement.

Noble goals, all. What remains to be seen is how achievable they are.

"Considering EHR adoption, depending on which statistic you believe, is at 25-30 percent, it will be ambitious just to have adoption rates at 80-90 percent in 2015," Webmenders' Howard says.

Adoption is only the beginning to what Blumenthal, during January, hailed as the era of Meaningful Use. Likewise, the ONC's second goal, of improving population health and reducing the cost of care, is unrealistic so soon, Howard adds, if only because "it will take implementing these technologies over years for us to see a vast reduction of cost."

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