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ONC’s 5-Year Federal Health IT Roadmap: Health Equity & AI

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Federal health IT officials unveiled a draft strategic plan outlining their priorities for health technology over the next five years. This plan places a strong emphasis on health equity and artificial intelligence (AI).

The draft plan (PDF), released by the Office of the National Coordinator for Health Information Technology (ONC) within the Department of Health and Human Services (HHS), outlines goals and objectives for federal health IT initiatives. These initiatives aim to improve health experiences and outcomes for individuals, entire populations, and communities. The plan also details how health IT can be leveraged to promote advancements in scientific discovery and innovation, bolster opportunities for health equity, and modernize the nation’s public health infrastructure.

This strategic plan serves a dual purpose. It functions as a roadmap for federal health IT activities and initiatives, while also acting as a catalyst for similar activities within the private sector.

“As part of our statutory duty to align and coordinate health IT efforts with our federal partners, ONC collaborated on the draft Plan with more than 25 federal agencies,” said Micky Tripathi, Ph.D., the national coordinator for health information technology. “These agencies regulate, purchase, develop, and use health IT to deliver care and improve health outcomes, and they increasingly rely on the access, exchange, and use of EHI to effectively execute their missions.”

In 2020, ONC released a previous five-year strategic plan that focused on promoting a modern health IT infrastructure. This plan successfully drove significant progress across government and industry in advancing the access, exchange, and use of EHI.

The new plan, released last week, builds upon this progress by placing a stronger emphasis on public health and health equity. It also acknowledges the growing use of AI in healthcare, addressing both the excitement and skepticism surrounding this technology.

“The draft plan acknowledges the swift evolution of AI and increased use in health care,” wrote ONC officials in a blog post. “It emphasizing the urgent need for the federal government to navigate this transformative landscape both responsibly and effectively in health and health care.”

The public has until May 28th to offer feedback and comments on the draft plan.

“The draft plan is deliberately outcomes-driven,” explained ONC officials Seth Pazinski, Peter Karras, and Dustin Charles in a blog post. “The goals and objectives focused on improving access to EHI, delivering a better, more equitable health care experience, and modernizing our nation’s public health infrastructure.”

The plan centers on four overarching goals: promoting health and wellness, enhancing the delivery and experience of care, accelerating research and innovation, and connecting the healthcare system with health data.

“The goals are divided into distinct categories,” they wrote. “Goals 1 through 3 addressing plans to improve the experiences and outcomes for health IT users, while goal 4 is focused on the policies and technologies needed to support those users.”

The strategic plan also aligns with other HHS priorities in the health technology sector. This includes a new regulation that mandates new technology upgrades while simultaneously promoting interoperability and transparency in predictive decision support tools. This final rule, titled “Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing (HTI-1),” established the first-ever nationwide requirements for transparency around AI and algorithms used in health IT.

According to ONC, the strategic plan also aligns with HHS’ strategy to bolster cybersecurity within the healthcare industry. Late last year, HHS released a healthcare cybersecurity concept paper alongside voluntary healthcare-specific Cybersecurity Performance Goals (CPGs) to assist healthcare organizations in prioritizing the implementation of high-impact cybersecurity practices.

The HHS concept paper outlined four major steps the department will take to advance healthcare cyber resiliency. These steps include establishing voluntary cybersecurity goals for the healthcare sector, providing resources to incentivize and implement cybersecurity practices, and implementing an HHS-wide strategy to support greater enforcement and accountability.

The American Hospital Association (AHA) expressed reservations about HHS’ efforts, pushing back against the “misguided concept paper” and its call for mandatory cybersecurity requirements solely for hospitals.

“HHS’ repeated references to this concept paper demonstrates the logically flawed emphasis on hospitals as the primary source of cyber risk in health care” wrote last week by John Riggi, AHA’s national advisor for cybersecurity and risk. “To make meaningful progress in the war on cybercrime, the federal government must be willing to take a strategic and holistic approach to this national security threat, not focusing on just one facet of the health care sector—hospitals. Any defensive strategy imposed on the health care sector must also be accompanied by an equally aggressive offensive cyber strategy by the government to counter the true source of cyber risk—foreign bad guys.”

Other healthcare organizations, however, voiced strong support for the draft plan.

“The Centers for Disease Control and Prevention (CDC) appreciates how the draft 2024-2030 Federal Health IT Strategic Plan addresses the need to continue to advance the nation’s public health data infrastructure, while making sure that it is benefiting the communities that need it most,” wrote Jim Jirjis, director of the CDC’s Data Policy and Standards Division, in a statement.

“As the VA modernizes its electronic health record system, the draft 2024-2030 Federal Health IT Strategic Plan provides direction towards a seamless health care experience that helps patients and providers benefit from a connected health system,” said Meg Marshall, director of informatics regulatory affairs at the Veterans Health Administration. “Not only that, the draft Federal Health IT Strategic Plan serves as an actionable roadmap for the federal government to align and coordinate health IT efforts in a transparent and accountable manner. We are looking for public comment about ways to improve health through health IT, so that Veterans too can benefit from the goals of a coordinated federal health IT strategy.”

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