A Committee member later said the issue of health reform makes it even more important to determine what kinds of data would be useful for future surveillance and performance assessment. He felt that the Committee should develop an opinion on this so that they can comment on this subject in the future. Dr. Fielding agreed that data recommendations would be important in supporting this effort. He said that this topic should be addressed by a subcommittee, but not at the January Committee meeting. Another member raised the role of primary prevention in the area of human development. He suggested that the Committee make recommendations in the realm of primary prevention, beyond immunization. Dr. Fielding asked the member to make sure the subcommittee addresses that issue, potentially designating primary prevention as a topic area.

Technical Assistance and Tools

A member explained that constituents are seeking a simple way to go from a health plan (e.g., deciding to improve diabetes quality and care and looking to set a level for that improvement) to a source. They want a more user-friendly guide to evidence-based public health actions than what is currently offered by the Cochrane Reviews, the Guide to Community Preventive Services, and the Clinical Guide to Preventive Services. Such a guide should offer an entry point that is less complicated, less comprehensive, and probably does not involve cost-effectiveness information. Dr. Remington and his colleagues are drafting such a document and will share it with the Committee in January.

Another member agreed that the Committee should apply the idea of simplicity throughout Healthy People 2020 to maintain effectiveness. Dr. Fielding concurred that it is always harder to keep things simple, but important do so. He added that, in looking for pools of evidence-based actions, Healthy People should include the work that goes on in other sectors to health. Health impact assessments and forecasting are valuable tools.

Dr. Fielding noted the need to provide Healthy People users with understandable tools. An example would be the Action Guides that the Partnership for Prevention created for the Centers for Disease Control and Prevention (CDC) to translate recommendations into practical "how to" guidance. (See: http://www.prevent.org/Initiatives/Action-Guides.aspx ). It’s an issue of translating of targets into action and going from a document that is designed as a reference to one that is useful for program planning and development. He suggested Committee members review the Action Guides for their January meeting. Dr. Fielding suggested that this issue be discussed at the meeting in January.

Systems Specifications Subcommittee

Given the Committee’s discussion of the desire for more specificity for the database, Dr. Fielding asked Dr. Ronald Manderscheid, Systems Specifications Subcommittee Chair, what would be a realistic scope of work for his group to undertake. Dr. Manderscheid recommended that the members not waste their time reviewing the first draft of his group’s report as a second draft would be produced for the January meeting. He went on to say that the document should lay out the underlying concepts for a query system that could replace the paper version of Healthy People 2020. It would use fixed queries from a fixed database to make it easier to access and use the data.

Dr. Manderscheid raised several questions that remain to be addressed, including the form for the basic database and the mode for accessing it. As the Healthy People 2020 system is built, people at the local level are going to want to upload data to compare themselves to the national benchmarks. In addition to these issues, Dr. Manderscheid said that the Committee should consider what the appropriate role for IT is within public health. Part of this is related to economic recovery because of the need to develop IT infrastructure. While he recognized that it would not be possible to pursue all of the possibilities now, he felt that the Committee should at least express an opinion about this issue. Dr. Fielding indicated that it would be helpful to know if the new administration will embrace a database format for Healthy People 2020. He recommended an IT subcommittee remain in place going forward.

VII.  Issues for Inclusion in the January Agenda

Dr. Fielding asked if there were other areas where the members felt it would be important to focus attention during their January meeting. He noted that there were four expert presentations planned, including Shawna Mercer (Branch Chief, CDC Community Guide); Ed Sondik, (Director, NCHS); Robert Pestronk (Executive Director, NACCHO); and Paul Jarris (Executive Director, ASTHO). He asked whether it would be helpful to have more interaction with the FIW. RADM Slade-Sawyer agreed that this would be a good opportunity for such interaction. He asked the Committee whether additional presentations or issues for discussion might be useful to add to the agenda. Suggestions included:

• A presentation from the Office of the National Coordinator for Health IT (ONCHIT)
• Comment from NCHS on the extent to which data gaps on health equity are or are not being closed.
• Exemplars of objectives that have successfully moved toward their targets, including tabulation by type of target setting method used.
• The results of the focus groups conducted by the subcommittee on User questions and Needs should also be addressed.

VIII.  Summary and Closing Remarks

Dr. Fielding thanked the Committee for their work over the course of a remarkable year.  He noted it is a time of trepidation and hardship for many, but it is also a time of great hope.