Health IT key to national health security plan

张琨

Health IT key to national health security plan By Brian Robinson
Tuesday, July 27, 2010

Development of ways to link regional health IT systems, as well as an information plan that maps what data flows, security and standards are need to ensure real-time communications between health organizations and emergency services, are some of the key elements of a plan for achieving U.S. national health security.
A draft of the Biennial Implementation Plan (BIP), published July 19 by the Department of Health and Human Services, is the first-ever attempt to pull together a national strategy for minimizing the health impact of natural and man-made disasters, disease outbreaks, and biological and other terrorist attacks.
The draft adds the first programmatic details of the National Health Security Strategy (NHSS), following an initial announcement of the initiative by HHS Secretary Kathleen Sebelius earlier this year. The plan was opened for public comment July 26.
The NHSS was mandated by The Pandemic and All Hazards Preparedness Act, enacted in the wake of the global H1N1 flu pandemic. The strategy will be revised every four years, but the HHS plans to update the implementation plan every two years.
The approach to developing the strategy won’t require a common database, where organizations would be required to submit their data which could then be accessed by others in the national network of responders. That’s a system that’s already been floated as the basis of many local and regional health information exchanges, and has been discarded by many.
Instead, the draft plan calls for “very specific requirements about how to link systems electronically, including specifying where linking is appropriate or not, providing applicable standards for doing so, and developing a process to guide how these will change over time.”
That could be easier said than done, however. As the plan also points out, there is currently no “overarching organizational structure” to ensure the kind of coordination that will be needed between a very broad range of stakeholders, and there’s no single entity that has the authority to implement the activities that will have to take place.
The Office of the National Coordinator for Health IT, which is overseeing the development of the National Health Information Network (NHIN), is listed in the plan as a “notional lead” for at least some of the activities. The Centers for Disease Control, Department of Homeland Security and the HHS Assistant Secretary for Preparedness and Response (ASPR) are other potential lead organizations.
The plan talks about the need for “adequate information technology and electronic health records (EHRs)” to be able to manage and track health-related events, as well as the development of a taxonomy of terms and measures that will be critical to assessing the capability of the health care system to deal with those events.
It also describes the use of new technologies such as social media to address some of the community-based informational systems that the NHSS will require.
However, the plan probably sets the greatest challenge to development of the NHSS in the first few pages of the document. “Given the current fiscal climate,” it says, “the BIP is built on the assumption that there will be no significant sums of new public funds available for national health security in the next two years.”
In what seems like a vast understatement, it goes on to say that the challenge is “to discover new and creative ways” of using existing resources more effectively as a way of building the NHSS.