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The Committee briefly reviewed the draft outline for the report. Key topics to be addressed included the value of prevention, health IT, and preparedness in public health. The committee moved on to discuss and finalize the preamble. Dr. Kumanyika indicated that the current draft incorporates the concepts of leadership, vision, and the belief that socioeconomic factors are critical determinants of health. It generally consists of motivational language outlining the purpose of the Healthy People 2020 objectives. Even though it says who the audiences are, it doesn't really state who is writing the preamble. She asked whether this document should be read as coming from the Secretary, or the Committee. The document does not convey a sense of governmental responsibility, but in some places seems to suggest that responsibility lies with citizens themselves. She felt it was important that the preamble not be silent on the issue of who is doing the talking.

Dr. Fielding expressed the view that this should be considered the preamble to the Committee's September report to the Secretary. The tone and language of the preamble would be directed toward the Secretary. NORC staff clarified that the current draft was based on a document that had been prepared in 2007 by a "Technical Expert Panel" that had convened to make recommendations for the Healthy People 2020 framework. That version had been intended to serve as a preamble to the Healthy People 2020 objectives themselves. After some discussion, the Committee felt that the document should be modified and offered to the Secretary as a suggestion for the HHS preamble. While the Committee is in an advisory role, they felt it would be important for the Secretary's voice to be behind the objectives. They agreed to modify the preamble draft as a suggested approach for the Secretary to consider.

Dr. Fielding noted that Ron Manderscheid had asked for time on the agenda to propose the addition of a new goal. Dr. Manderscheid asked the committee to consider adding a goal on health information technology and health communication. He summarized the work that he had done with some representatives of the FIW who have been addressing these issues. They defined a set of requirements having to do with what type of information technology system population health should have, how it should be driven, what role health communication should have, and how efforts should relate to the Office of the National Coordinator for Health IT (ONC) strategic plan. Dr. Manderscheid went on to say that Healthy People 2020 should include a strong focus on health IT and health communication. He described early planning to create a "Healthy People Community" that would include the IT infrastructure for Healthy People 2020. He described these plans in detail.

Dr. Fielding noted that Dr. Manderscheid's presentation was, in essence, the outline for the health IT section in the final report. He asked whether this would be a Committee product that would be endorsed by the FIW. Dr. Manderscheid clarified that it would be both an Advisory Committee and FIW product. He thought the two groups should carry the same message as frequently as possible, although there are differences between the groups. Dr. Fielding agreed that it makes sense to harmonize whenever possible, although these are two different groups with different charges. He asked Dr. Manderscheid to produce a draft of the document by August.

A Committee member pointed out that, historically, the goals have been broad statements of what Healthy People 2020 will achieve and cautioned against including processes and infrastructure issues. Another member asked whether technology-based health literacy has been discussed. Dr. Manderscheid indicated that health literacy will be part of the health IT subgroup's efforts, and that this will be part of the recommendations that will be made. Dr. Fielding suggested that health IT may be how to achieve the goals, rather than a goal in itself. The issue of whether to consider an additional goal about health IT was tabled until the next meeting.

VIII.  Preparations for the September Meeting

The September meeting will involve reviewing an integrated draft of a final report for Phase I of the Committee's activities, as well as an initial foray into topics for Phase II of the group's work. Topics that will be important to address include the organizational structure of the Healthy People report or database. The Committee will also work with ODPHP to clarify the charge for the second year of its work. NORC will distribute a draft of the report in advance of the September meeting, and Committee members should plan to comment on that fairly quickly. Dr. Fielding said that the main task for the September meeting will be to get final agreement on the Advisory Committee's Phase I report to the Secretary.

With regard to logistics for the next meeting, Dr. Fielding said it might be best to use WebEx as a vehicle for future meetings—even if they are full day meetings on successive days. After some discussion, the group agreed that the September meeting would consist of two WebEx meetings lasting six hours each; members should block off time in the afternoons of both days so that they can work on writing assignments.

IX.  Summary and Closing Remarks

Dr. Fielding thanked the Committee members for their commitment to this very important process, and expressed his hopes that their work would be helpful to the HHS Secretary and to the FIW.

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