Comments on Goal I of the ONC HealthIT Strategic Plan

On Monday, I looked at the differences between the 2008 ONC Strategic plan and the 2011 Strategic plan.  Today I'm looking at the first goal and providing a little bit more coherent response now that I'm no longer fuzzy.

Goal I: Achieve Adoption and Information Exchange through Meaningful Use of Health IT
Objective A: Accelerate Adoption of Electronic Health Records
This objective focuses on financial incentives, workforce education, implementation assistance and communication with providers. The main thing missing here is a truly focused marketing effort to get providers to adopt EHR technology. I don't know how many times I've been in a room in the last year filled with doctors, to find that many still haven't heard of Meaningful Use. In addition to marketing to providers, we also need to encourage patient engagement with their providers on this topic. Patients  have a role in encouraging their doctors to use EHR technology, and to share health information electronically.  Something like this commercial could work to create greater demand.
Objective B: Facilitate information exchange to support meaningful use of electronic health records
This part of the plan is weak.  It talks about fostering business models for exchange, but in the same section talks about The Direct Project, which is is a technology platform, not a business model.  It also talks about the S and I Framework initiatives in the context of advancing data interoperability, but ignores much of what has already been done around HIEs.  It spends several paragraphs talking about S and I Framework, which is addressing content to be exchanged rather than mechanisms supporting exchange, and barely touches on the half billion dollar State HIE program.  More needs to be done to facilitate and encourage exchange using existing technologies readily available, rather than reinvention.
Objective C: Support health IT adoption and information exchange for public health and populations with unique needs
This one is an interesting combination that I would have separated into two pieces: public health and addressing population disparities.  CDC's efforts in public health are many, but I'm not sure that their collaboration with State public health agencies is as effective as it could be.  I'm not really familiar enough with programs around health disparities to comment so I won't.  On supporting long term/post-acute care, I can see where the Transitions of Care project will help, and I'm encouraged that SAMHSA is considering incentives for use of EHR in the behavioral health community.