ONC strategic plan raises diverse concerns

The Office of the National Coordinator for Health IT's draft strategic plan for 2015-2020 has not been met with open arms, garnering a large number of wide ranging comments about the agency, its goals and the overall direction of health IT.

The plan, released Dec. 8, 2014, includes five updated goals, such as more interoperability, expanded electronic health record adoption and more use of health IT in research; it received about 400 comments and covers about 28 pages on ONC's website. Some of the comments were targeted, such as the ability of behavioral health providers to access EHRs or the impact on certain patient groups, such as persons with disabilities. Several commenters requested more specificity; others, such as the American Academy of Ophthalmology, used the forum to express frustration with the Meaningful Use program.

Perhaps not surprisingly, many of the comments were focused on the privacy and security of patient records, the government's inability to keep the data safe and the need for patients to provide consent before their data is shared. A lot of consumer commenters expressed concern that the contemplated data sharing would put the records at risk of hacking and identity theft.

Individuals were not the only commenters worried about safeguarding patient data. For instance, the American Psychoanalytic Association recommended that ONC "eliminate statements" in the plan that "give the public the false impression that electronic health information systems can be made secure." It also suggested that ONC inform the public that "there is no such thing" as a secure electronic health information system.

"In addition, the strategic plan should state the reasons why these systems present a greater threat to patient privacy than paper records," the association states.

Still, others questioned why the government should be involved at all, echoing sentiments by the National Center for Policy Analysis, which suggested that ONC step back and let market forces control health IT.

The final strategic plan is expected later this year.

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