The Office of the National Coordinator for Health IT (ONC) released a report on January 29 that identifies optimal healthcare information exchange and implementation standards to enable a nationally interoperable health data information exchange system by 2017 (i.e. standards so that you can have your health records sent and read by all your doctors).
In healthcare, interoperability of IT systems allows providers to share data among different practitioners, insurers, billing and scheduling systems and health information exchanges. Interoperability has the potential to improve the quality of patient care by providing access to accurate, timely information in one location, save time previously used searching for information, and make critical medical information instantly available for clinical decisions.
Under the 2009 economic stimulus legislation’s electronic health records (EHR) incentive payment program, the ONC was directed to establish a governance mechanism for the nationwide health information network. Since that time, however, the ONC has been under increasing criticism about the lack of interoperability of EHRs despite the significant public investment.
The report, “Connecting Health and Care for the Nation, A Shared Nationwide Interoperability Roadmap,” calls for most providers to adopt systems that can send, receive and use “a common set of electronic clinical information ... at the nationwide level by the end of 2017.” The common data set consists of about 20 basic elements, such as patient demographics, lab test results and identifiers for a patient's care team members. The ONC proposes a public-private partnership to create a governance framework to harmonize this data exchange.
Moreover, according to the report, the federal initiative is taking cues from EHR best practices at the regional and statewide level. But while these success stories exist, the ONC cites consensus among healthcare organizations that there is discord concerning which information exchange standards to use, how to configure computer systems to use them, and which rules and business practices to follow.
Increasing the use of application provider interfaces - de facto in the technology industry since the rise of the smartphone era - is one of the ONC‘s recommendations that can help reconcile those inconsistencies. “One of the guiding principles for the Roadmap is the notion of modularity: complex systems are more durable under changing circumstances when they are divided into independent components that can be connected together,” the report states.
The report also proposes better education for providers and their health information exchange partners on federal privacy and security rules to encourage data sharing, as well as new incentives for interoperability beyond those in the EHR incentive payment program.
Improved interoperability of health information is crucial for providers seeking to create population-based care management systems and accountable care organizations in response to government and private sector payment reforms that favor performance-based compensation. While the ONC’s 166-page report is still in draft form - and is open for public comment through April 3 - it represents a step toward the interoperability many in healthcare have rallied for but have yet been unable to realize.