Data Council Work Plan

Agenda Item 5.

Provide a Forum for Coordination of Health and Human Services Issues Raised by the Expanding National Information Infrastructure (NII) Activities.

Objective 1: Coordinate and advance Federal strategies for overcoming the barriers to the effective use of telemedicine in the United States and, where appropriate, internationally.

Specific action items:

1. Create an effective inter-departmental working group that includes representatives of all Federal agencies with active telemedicine programs (Joint Working Group on Telemedicine).
   1. Recruit membership
   2. Establish schedule of bi-weekly meetings staffed by the Office of Rural Health Policy
   3. Establish processes and procedures for working group
2. Utilizing the interactive capabilities of the Internet, develop an ongoing telemedicine inventory, geographic information system, and evaluation data base for Federally funded projects that can be easily maintained and ultimately expanded to encompass state and private-sector funded projects.
   1. Develop a common set of definitions to be used in creating the data base and determine the common elements that are to be collected by each agency and their grantees.
   2. Create the software to be used in developing telemedicine web pages which will contain the basic data on each agency's projects.
   3. Develop simplified "search engine" programs that facilitate extracting of information from the web pages to create inventories and analytic reports.
   4. Create geo-coded linked files with other data bases to establish a telemedicine evaluation information system.
   5. Demonstrate information system to Vice President.
3. Create an evaluation framework that will allow federal agencies to more effectively share and interpret evaluation results across projects funded.
   1. Develop an initial framework and circulate it widely for comment.
   2. Refine framework based on comments.
   3. Pilot test framework.
   4. Incorporate framework in agency evaluation activities, where feasible.
   5. Promote the conduct of cooperative evaluations based on framework.
4. Clarify FDA policies regarding telemedicine.
   1. Develop a white paper that outlines FDA's current activities in regulating telemedicine and proposed future directions.
   2. Disseminate paper widely for comment by all relevant public and private sector interests.
   3. Issue revised paper and, where appropriate, clarify existing or establish new regulatory policies.
5. Recommend options to both the Administration and the Congress for overcoming the legal barriers to telemedicine.
   1. In collaboration with the AMA, the Federation of State Medical Boards, the Center for Telemedicine Law, and other interested parties, develop a comprehensive discussion paper on the legal barriers to telemedicine and options for overcoming those barriers.
   2. Convene a workshop of knowledgeable individuals to review and evaluate the options paper.
   3. Forward final options paper to the Vice President and to the Congress (as part of mandated report, due January 1997).
6. Promote cost-effective payment policies for telemedicine.
   1. Work with HCFA to develop demonstrations, both under fee-for-service and managed care, that evaluate alternatives for paying for telemedicine consults under Medicare.
   2. Work with HCFA and state Medicaid agencies to assess Medicaid's experience in paying for telemedicine.
   3. Synthesize information on the cost-effectiveness of telemedicine services in closed systems (e.g., VA and DOD health care facilities).
   4. Synthesize information from the literature and the few managed care plans that cover telemedicine (e.g., Allina Health System) to evaluate the barriers to managed care in those settings and delineate possible actions that might be taken by the Federal government to assist in addressing the barriers identified.
7. Assist the Federal Communications Commission in developing Federal regulatory policies that promote building of the information infrastructure in rural and underserved urban communities.
   1. Provide timely comments on the FCC Proposed Rule for implementing the universal service provisions of the recently passed 1996 Telecommunications Reform Act.
   2. Work with FCC staff in evaluating the comments received.
   3. Provide ongoing advice to the FCC regarding potential regulatory actions to stimulate the development of modern telecommunications systems that support health care services in underserved urban and rural communities.
8. Explore the development of a Federal or federally-sponsored telemedicine laboratory to assess the efficacy and technical reliability of commercially available telemedicine technologies.
   1. Assess the current status of similar laboratories already being operated by Federal agencies (e.g., VA) and similar non-federal laboratories.
   2. Determine the economic and logistic feasibility of expanding these laboratories to serve all federal agencies and their grantees.
9. Prepare a report to the Congress by January 31, 1997, in accordance with the requirements of the recent Telecommunications Reform Act (P.L. 104-104).
   1. Establish clearance procedures and time-line for report.
   2. Draft outline of report and assign chapter responsibilities to members of the Working Group.
   3. Submit draft chapters to appropriate bodies for review.
   4. Revise report and submit final report to Secretary of Commerce for transmittal to Congress.

Objective 2. Coordinate, and where appropriate, develop policies and adopt and implement recommendations regarding access to and use of health and human services data available on the NII.

Specific action items:

1. Develop an approach to inter-departmental coordination for Enhanced Health Information for Consumers.
   1. Develop policies and priorities for electronic dissemination of federal health and social services information.
   2. Develop policies regarding links from electronic sources of federal health and social services information to privately maintained sources.
   3. Develop policies which encourage the use of such electronic information by state and local public health, health care, and social services personnel.

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Last updated 7/3/96.