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An Information-Rich Ecosystem

    Collaborative Comments in Response to the Office of the National Coordinator’s Request for Information regarding the PCAST Report on Health IT
  • Publication Date: 
    Wednesday, January 19, 2011

    Download Executive Summary
    Download Collaborative Comments


    The President‘s Council of Advisors on Science and Technology (PCAST) report Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans envisions an information-rich health ecosystem. Like PCAST, we seek to accelerate the use of modern information tools to improve health outcomes, increase the cost-effectiveness of care, and encourage innovation while protecting privacy.

    Markle Connecting for Health, a public-private collaborative of more than 100 organizations across the spectrum of health care and information technology (IT), appreciates the opportunity the Office of the National Coordinator for Health Information Technology (ONC) has provided for commentary on this very important report.

    Our comments fall into three parts. We start by addressing the basic parameters of the PCAST vision, one that has many parallels to the Markle Connecting for Health Common Framework (Markle Common Framework). Next we provide input on some of the specific recommendations of the report, and here our comments fall into two categories: As in all of our past work, we emphasize the importance of starting with clear goals and a policy framework to guide technology choices and solutions, and we consider some of the novel technology approaches that PCAST proposes and their implications for the vast, heterogeneous environment that characterizes US health care today. Lastly, based on the collective experience of our broad collaboration, which has worked together on solutions to health IT challenges for nearly a decade, we provide ONC a set of forward-looking recommendations that we believe can accelerate the use of health IT to improve health outcomes and cost effectiveness while protecting privacy.

    A Vision Supported by the Markle Connecting for Health Common Framework

    The PCAST report offers a compelling vision for an information-rich health care system that we support. The Markle Common Framework is aligned with and supportive of the PCAST vision for:

    • A nationwide capability for secure health information exchange using the Internet, not a new network.
    • A distributed network for information-sharing.
    • A model for linking patient information across sites of care using existing identifiers.
    • An approach to technology that emphasizes innovation and a diversity of solutions to support broad participation and new entrants.
    • A comprehensive set of privacy and security practices to support trust in information sharing.
    • A universal exchange language for sharing health information securely over the Internet.
    • Population health improvement and analysis using distributed networks.

    However, we also identify areas for further development and analysis based on our experience with three foundational principles. These principles, which have guided our work for nearly a decade, most notably the Markle Connecting for Health Common Framework, offer grounding for our comments on the PCAST report.