Marsha K. Millonig
Marsha K. Millonig B.Pharm., M.B.A.

My last column focused on the sunsetting of the Office of the National Coordinator for Health Information Technology’s (ONC) Shared Nationwide Interoperability Roadmap because of successes in meeting milestones within the roadmap. Federal health IT efforts will now be guided by regulations implementing technology components of the 21st Century Cures Act and the 2020-2025 Federal Health IT Strategic Plan. That plan was released with little fanfare in October of 2020 during the COVID-19 pandemic. According to then national coordinator, Donald Rucker, M.D., the plan’s aim is to outline concrete steps that federal partners can take to improve health through health IT. The plan’s goals, objectives, and strategies highlight how important electronic health information is, including how it is enabled by public health surveillance, telehealth, and remote monitoring. He notes that while gains have been made, much work remains to ensure patients and caregivers have access to “valuable, usable information.”

More than 67% of those surveyed want their doctors, hospitals, and other health providers to share advanced care plans, end-of-life preferences, images, and family medical histories.

That is an important aim and one that aligns with public opinion, according to a recent survey by the University of Chicago’s AmeriSpeak Panel of the U.S. household population commissioned by the Pew Charitable Trusts. A representative sample of 1,213 adults ages 18 and older was queried both by phone and online about sharing their electronic healthcare data. The majority of those surveyed support efforts that improve how their health data is shared among their physicians and other care providers, and they want better access to their own healthcare data, including X-rays, CT scans, and other imaging. Fully 81% said they would support enabling different healthcare providers to share patient health record information between their EHR systems when they are caring for the same patient. More than 67% of those surveyed want their doctors, hospitals, and other health providers to share advanced care plans, end-of-life preferences, images, and family medical histories. A majority also would like the capability to download their healthcare data to applications on mobile devices, especially if the apps were preapproved by doctors, hospitals, or independent boards. The COVID-19 pandemic made respondents more likely to support provider data sharing, although the pandemic did not influence their opinions on downloading data to apps or whether there should be government standards to improve data matching between providers.

The new federal health IT five-year strategic plan supports easier data sharing. It is an outcomes-driven plan designed to meet the needs of patients, caregivers, health providers, payers, researchers, developers, and innovators. The federal HIT vision remains the same: a health system that uses information to engage individuals, lower costs, deliver high-quality care, and improve individual and population health. Its mission is to “Improve the health and well-being of individuals and communities using technology and health information that is accessible when and where it matters most.” Sounds like a great match between the plan and public opinion.

The plan consists of six federal health principles:

  1. Put individuals first. This means embracing patient-centered care that values the whole individual, including the patient’s goals, values, culture, and privacy.
  2. Focus on value. This is promoting and pursuing activities that improve health and care quality, efficiency, safety, affordability, equity, effectiveness, and access.
  3. Build a culture of secure access to health information. This is supporting secure health information access, exchange, and use by individuals, caregivers, providers, public health professionals, and other stakeholders.
  4. Put research into action. This is strengthening feedback loops between scientific, public health, and healthcare communities to efficiently translate evidence into clinical practice and improvement.
  5. Encourage innovation and competition. This is supporting and protecting innovation and competition in health IT that result in new solutions and business models for better care and improved outcomes.
  6. Be a responsible steward. This is developing health IT policies though open, transparent, and accountable processes that use federal resources judiciously while leveraging private sector expertise to provide technology and services to execute on the policies.

The plan’s four major goals embody these principles and include:

  1. Promoting health and wellness
  2. Enhancing care delivery and experience
  3. Building a secure, data-driven ecosystem to accelerate research and innovation
  4. Connecting healthcare with health data.

The 14 specific objectives associated with each goal may be found within the plan.


The plan also outlines opportunities that exist within a digital health system, including:

  • Empowering patients.
  • Moving to value-based care.
  • Advancing interoperability.
  • Promoting new technologies.
  • Reducing regulatory and administrative burdens. Protecting health information privacy and security.

Patient empowerment will be aided by 21st Century Cures Act regulations about standards-based application programming interfaces (APIs), which I talked about in my last two columns related to the roadmap sunsetting and the FDA’s Digital Health Center of Excellence. Continued emphasis on the government’s health program incentives will move the needle forward toward value-based care, including driving interoperability by using Health Level Seven’s Fast Healthcare Interoperability Resources (FHIR) for APIs. Improved broadband access is noted as another driver of new and expanded technologies, including telehealth.

Importantly, the plan was developed in coordination across 25 federal organization that are involved in health IT. Authors note that their work in developing the plan was motivated by the constant evolution of mobile and web apps and medical devices, as well as the increased reliance by both the public and private sectors on interoperable health IT and information. The report’s architects would like it used to prioritize resources; align and coordinate efforts; signal priorities to the private sector; and allow for benchmarking and program assessment. I encourage all ComputerTalk readers to download the plan and scan its goals, objectives, and strategies to see how they may help drive innovation in their companies and organizations. CT

Marsha K. Millonig, B.Pharm., M.B.A., is president and CEO of Catalyst Enterprises, LLC, and an associate fellow at the University of Minnesota College of Pharmacy Center for Leading Healthcare Change. The author can be reached at mmillonig@catalystenterprises.net.

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