About: How Was the Framework for the eHI Blueprint Developed?

In a report published by the California HealthCare Foundation, It Takes a Region: Creating a Framework to Improve Chronic Disease Care, Dr. Ed Wagner and colleagues at the MacColl Institute for Healthcare state that “in the absence of substantial national healthcare reform, regional quality improvement efforts appear to offer the best hope for transforming American healthcare.”² The study examined communities and regions across the United States where public and private stakeholders were collaborating to improve healthcare through better quality and reduced costs.

Based on interviews with coalition leaders and findings from literature reviews, Wagner and his colleagues suggested a framework of four common strategies that “create the environment and provide critical paths” for transforming care, which include:

Data-Sharing for Performance Measurement
Engaging Consumers
Improving Health Care Delivery
Aligning Benefits and Finances

These themes also align with the findings of many organizations focused on improving healthcare in the public and private sectors. As eHI embarked on the creation of the Blueprint, it became clear that the Blueprint must focus on how health and healthcare improvement strategies can be strengthened by health IT and health information exchange, in recognition of the fact that health IT is an enabling infrastructure, but not the end goal.

As a result, this framework was adopted for the eHI Blueprint. While Wagner and his colleagues employed a regional focus in their study, the Blueprint principles, strategies and actions are intended for a broad range of stakeholders both at the national and local levels who are committed to achieving such a challenging, but critical transformation.

In addition to adapting Wagner et al’s four healthcare improvement strategies, eHI’s leadership added one enabler critical to leveraging health IT and information exchange in transforming healthcare – privacy, security and confidentiality. Combined with improvement strategies, these five areas serve as the framework for the Blueprint:

eHI Blueprint Framework	Wagner Framework
Engaging Consumers	Engaging Consumers
Transforming Care Delivery at the Point of Care	Improving Health Care Delivery
Improving Population Health	Data-Sharing for Performance Measurement
Aligning Financial and Other Incentives	Aligning Benefits and Finances
Managing Privacy, Security & Confidentiality in the Use of Electronic Health Information

Consensus among the diverse stakeholders in healthcare on principles, strategies and specific actions in each of these areas became the goal of five committees that were created to develop the Blueprint.