ONC Musings on Engaging their Stakeholders

The Office of the National Coordinator for Health IT in the US (more commonly known as the ONC) continues to amaze me with their willingness to listen to and react to what they are hear from their stakeholders.  In a recent post on HealthITBuzz, the ONC blog, Jodi G. Daniel, Director of the Office of Policy and Planning, shares her thoughts on what the ONC has learned from the input they have received to date.  Highlights include:

  • “We should take greater advantage of social networking tools (and this means much more than blogging) when bringing our policy conversations outside of the walls of HHS.”
  • “We have been reconsidering the label “consumer” and thinking about using “individual” instead. Calling people consumers implies that they are necessarily consuming something, whereas an individual may not need to consume anything (health care or otherwise) to manage his/her health more effectively.”
  • “It is not just about changing the behavior of consumers. Health IT offers a tremendous opportunity to change the health care system to become more “consumer-centered.”
  • “In order to include consumers in the health IT policymaking process, we cannot expect them to come to Washington or to find this blog online (although the ones that do are amazing!). To truly be representative, we must go to consumers’ conversations.”
  • “Data liquidity, including consumer access to their health information, is the first step to fostering innovation. Innovation is not just about technology; there is also a real need for innovation on implementation, replicating successes, and using data in advanced ways. But it is the industry that will be leading any such innovation, not the government.”

Engaging the community using social media is a scary prospect for many healthcare organizations.  Fortunately, there are some good role models to emulate and many great resources from which to draw ideas and lessons learned.




4 responses to “ONC Musings on Engaging their Stakeholders

  1. This forum seems to be populated by analysts and industry people. Any MD’s out there?

    Well I am one and I can tell you I am highly skeptical about eHealth. Why? From my little experience here in BC, the industry seems to be populated by consultants who hop back and forth from private to public sector with uncanny ease, and bureaucrats who find a project and then seem to perpetuate it forever, regardless of whether it is practical or needed. The whole system is full of people who just take the money and GET NOTHING DONE. Forget about the blindingly huge conflicts of interest – I won’t even go there right now.

    For example, what exactly has happened to the over 100 million given to Sun Microsystems (a company with almost no experience in Health IT) to create the BC health IT network? Weren’t we all supposed to have access to lab data or at least electronic downloading of discharge letters from hospitals years ago? Why is ANOTHER private company doing a chunk of this (giving us lab data) and doing it at no cost to the taxpayer?

    Why have individual Health Authorities employed teams of web developers to build applications no one wants or will ever use? Why have some of the “managers” of these projects been employed for 5-10 years without creating anything of demonstrable value?

    Why did BC spend millions on the e-MS project to develop an “electronic medical summary” standard when such standards had long been established and published elsewhere?

    Why did the BC Ministry of Health change the vendor for the PHSA CIS without consulting the clinicians EVEN THOUGH the Ministry choice was inferior and the subject of a medical journal article showing increased morbidity and mortality in a US Children’s Hospital following its deployment? Did they realize they had chosen this vendor for BC’s Children’s Hospital?

    Why is PITO a failure? What has caused it to “hit the wall” with little headway (new MD’s signed up) over the last year? There’s something we all need to understand right now: the majority of MD’s in BC don’t want an EMR in their office. Why? Because they know it will raise their overhead and reduce the number of patients they see – regardless of the claims to the contrary from the EMR vendors. If the government wants full adoption of programs like PITO they have two choices: pay the full cost plus a generous ongoing incentive OR wait 10-15 years until the aging majority of physicians have retired.

    Why on earth did the Ministry approve and fund the development of CHARD? How much did it cost and why didn’t they realize it was likely to be ineffective? How many physicians have actually signed on or used it once? Has any physician actually used it more than once?

    My gut feeling as to how to remedy the Health IT situation? We need to:

    Abolish Canada Health Infoway

    Clear out the amateurs and hire seasoned eHealth Managers/Officials/Vendors from places where it has worked (UK/Scandanavia)

    Continue to do the bare minimum for now – PACS/Lab Data/Summaries&Letters from Hospitals to FP’s

    Sort out Privacy/FOI/Patients Rights before building some monster of a central patient record repository whose data is then compromised

    Disallow individuals in eHealth moving from public to private sectors (ie
    a 5 year “cool off period” would be appropriate)

    Aggressively audit the system and kill any programs that are outdated, inappropriate or just plain useless

    Use money saved to increase chronic care beds, emergency services, cancer care and dementia care. We’ll get far more bang for our buck out of this than we’ll get from eHealth for the near and intermediate term.

  2. Interesting perspective from BC. It would be nice to hear an Ontario physician perspective…

  3. Read my article on eHealth Ontario that was published in Mar 2010 in Canadian Healthcare Technology. I know Mike doesn’t agree with it, but then he’s not a physician!



  4. Karim,
    Thank you for your comments. You are one of the people whose views I respect and track. With regards to your comment, you raised several points that I’d like to address:

    – I am not a physician. Absolutely true. I am an industry analyst. In this role I strive to understand and reflect the views of all stakeholders. In particular, I am keenly interested in promoting the views of those directly involved in the healthcare delivery process, notably clinicians and patients. Hence, I am thrilled to have physicians reading and commenting on the eHealthMusings blog.
    – I have no major objections to your CHT article. Indeed, I am dismayed that you would think that that I would not agree with what you said in your article. I agree wholeheartedly, for example, that physicians need play a more substantial role in the management and governance of eHealth related organizations like eHealth Ontario. I have even written several blog posts in this regard. I also feel strongly that EMR software is still quite immature and that EMR usability will become an increasing significant barrier. Again, I have written several articles and blog posts on this topic. Finally, I share your concern regarding the relatively simple and perhaps misleading metrics used to convey eHealth progress and have written several articles lately addressing this concern.


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