A Vision for “Person at the Center”


“Unleashing the Power of Each
Individual to Manage Their Health and
Partner in Their Health Care, Enabled
by Information and Technology”

LAST FALL the Office of the National Coordinator for Health Information Technology (ONC) brought together a diverse group of health experts to create a new vision of how technology can help with the self-management and shared management of healthcare.

The group was diverse indeed, including not just the expected experts from major government health institutions, hospitals, and universities, but also patient advocates and consumer health technology innovators (including yours truly).

It was a big time commitment on everyone’s part. Over the course of several months, there were lots of meetings, lots of papers to read, differences to resolve, but at last the group’s final report has been published and in my opinion, it’s monumental.

The paper begins with a bang by pointing out the vision for “Person at the Center” is far ahead of current thinking, and a whole lot of work needs to be done:

While the concept of “patient-centered health care” has been emerging over the past decade, there is vast distance between that concept and a truly “person-centric” vision that embraces the value of the individual inside and outside the healthcare system for improving both health and health care. The current health care environment emphasizes episodic activities centralized in health care settings and does little to provide resources for people and their families where they live, work, and play.

The paper goes on to describe a vision for the future in which individuals are empowered, via information and technology, to be active in managing their health and partnering in their health care.

The core values that underpin this vision are laid out.

The paper also describes, in some depth, goals for “Self-management and Prevention”, “Interactions”, and “Shared Management”, and specific “building blocks” that will be required to make these goals a reality. Many of these building blocks implicitly note that we’ve got to move beyond current mainstream thinking, such as:

  • Efforts to motivate individual behavior change should go beyond traditional approaches (e.g., education about nutrition and exercise) to include self-learning and critical-thinking skills.
  • Consumer eHealth tools should be widely available for testing, self-assessment, and care decisions outside of a medical setting.
  • The role of the [family] caregiver as a partner in shared decision-making should be valued and enabled with relevant tools.

The paper acknowledges both the opportunities and challenges ahead:

Person-centered health and health care represents a leap in how individuals and providers can and likely will relate to each other and how information will be shared, enabled by health information technology. Because it requires changes for consumers, patients, caregivers, individual providers, health care organizations, and the health care system itself, this evolution will require a wide range of efforts by all stakeholders over an extended period of time. … As this policy framework highlights, these changes offer significant promise for providers, consumers, caregivers, technology innovators, and society at large.

Throughout the project, I was impressed by both the diversity of strongly held and well-thought-out perspectives as well as the willingness of the participants to listen to, to consider, and even to be guided by other points-of-view. We all had to think deeply to be able to explain our views clearly to the rest of the group.

It made for a rich, intellectual stew.

I would urge everyone interested in consumer health innovation to read this white paper. You can find an executive summary and a pdf of the complete final report at this link.

Note: My recent speech, “Health Technology for the Other 99%” began as a presentation I made at the ONC workshop.
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