Patient Centered Care and Health IT

Dear Dr. Blumenthal (head of ONC)

1) REASON FOR NOTE - Congratulations on your amazing ability to do so much in so little time and your appearance on the HHS web cast last week with Secretary Sebelus. You asked me to keep in touch but I have held back until now since I know how many different stakeholders needs you are responding to but I concerned that ONC is making a very classic error that we often see in complex software implementations, so I am going to expend some of my very limited social capital and share with you what I see.

2) PATIENT CENTERED CARE SYSTEM - In order for us to have a patient - centered health care system we need to not only "listen" but invite consumers to design and co-create the systems that support that value. You can't simply "listen" to them, you need to engage them as co-creators and not simply ask them to adopt a system after it is ready for delivery. It is similar to putting consumers on hospital patient safety committees versus asking someone who has MRSA if they are taking their meds.

3) FAILURE TO ENGAGE ALL STAKEHOLDERS - One of the very well documented reasons that large complex software implementations fail is because the leadership doesn't identify and "engage" a key stakeholder group early on. I hope most people at ONC realize that it will be our ability to communicate and engage both providers as well as consumers (clients) and not the technology (certification, standards, open source, etc) that will make or break this project and out ability to meet the goals of the authorizing legislation.

4) LESSONS FROM OBAMA CAMPAIGN - At its core this is a political campaign and I am sure you realize that we never would have elected President Obama nor brought about change unless we had pro-actively asked people to be involved all throughout the campaign. It wouldn't have worked if we had simply wanted until it was close to the time to vote and then asked them to support us and we need to use that same technique for health IT or we risk losing control of the message.Although very few congressmen voted for the stimulus package, health information technology has pretty broad political support thankfully so it gives us a chance to work in a bi-partisian manner and reach out to as many patients and consumers during the design stage as possible.

5) ASK - So please consider implementing a matrix approach that includes a strong consumer engagement and communication piece that cuts across all of your program planning now instead of developing a system, presenting it to consumers and then asking them to support it.

Sherry (no I didn't send it)