ONC aims for improved interoperability by 2017

The Office of the National Coordinator of Health Information Technology (ONC) is aiming for better national interoperability by 2017.

In a new report titled "Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap," National Coordinator for Health IT Karen B. DeSalvo, MD, MPH, says the three goals over the next decade include requiring interoperability standards, motivating the use of standards through incentives and improving the collection and sharing of health information.

The report is a draft roadmap to deliver better care and result in healthier people through the safe and secure exchange and use of electronic health information, according to the ONC.

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“HHS is working to achieve a better health care system with healthier patients, but to do that, we need to ensure that information is available both to consumers and their doctors,” says U.S. Health and Human Services (HHS) Secretary Sylvia M. Burwell. “Great progress has been made to digitize the care experience, and now it’s time to free up this data so patients and providers can securely access their health information when and where they need it. A successful learning system relies on an interoperable health IT system where information can be collected, shared, and used to improve health, facilitate research, and inform clinical outcomes. This roadmap explains what we can do over the next three years to get there.”

The draft roadmap is a continuation of a vision paper for interoperability that was released in 2014.

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“To realize better care and the vision of a learning health system, we will work together across the public and private sectors to clearly define standards, motivate their use through clear incentives, and establish trust in the health IT ecosystem through defining the rules of engagement. We look forward to working collaboratively and systematically with federal, state and private sector partners to see that electronic health information is available when and where it matters,” says DeSalvo.

The roadmaps will be linked to efforts within the administration’s Precision Medicine Initiative, which aims to improve the care and speed of new treatments, and HHS efforts to improve healthcare quality and costs. The focus of HHS’ efforts are provider payments, improving innovative care delivery, and better information sharing.

The new report is open for comment and calls on the ONC to identify the best available technical standards for interoperability functions. The 166-page draft can be viewed at www.healthit.gov/interoperability and the public comment period is open until April 3.

NEXT PAGE: Read Karen DeSalvo's letter about the interoperability goals

Karen DeSalvo's letter that introduces the roadmap.

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In June 2014, the Office of the National Coordinator for Health Information Technology (ONC) laid out a vision for a future health IT ecosystem where electronic health information is appropriately and readily available to empower consumers, support clinical decision-making, inform population and public health and value based payment, and advance science.

In "Connecting Health and Care for the Nation: A 10- Year Vision to Achieve an Interoperable Health IT Infrastructure" (ONC’s 10-Year Interoperability Concept Paper), ONC committed to leading and collaborating with the health IT and health sector to define a shared Roadmap for achieving interoperable health IT that supports a broad scale learning health system by 2024.

This Roadmap reflects the result of that collaborative work with federal, state and private partners. It lays out a plan for what needs to happen, by when, and by whom, to see that electronic health information is available when and where it matters most for those we are here to serve: the American people. In the decade since ONC began its service to the nation, the United States has experienced remarkable progress in the digitization of the health experience.

There has also been significant advancement of payment reform that is driving the need for better visibility of the care experience and demand for straightforward quality measurement. Consumers are increasingly expecting their electronic health data to be available when and where it matters to them, just as their data is in other sectors. And new technology is allowing for a more accessible, affordable and innovative approach.

However, barriers remain to the seamless sharing and use of electronic health information. This draft Roadmap proposes critical actions that the public and private sector need to take to advance the country towards an interoperable health IT ecosystem over the next 10 years. Achieving such an interoperable system is an essential element towards HHS Secretary Sylvia Burwell’s vision of better care through smarter spending, leading to healthier people.

Achieving that better care system and better health for all will, through health IT interoperability, require work in 3 critical pathways: 1) Requiring standards; 2) Motivating the use of those standards through appropriate incentives; and 3) Creating a trusted environment for the collecting, sharing and using of electronic health information.

It will require us to agree to a set of rules of engagement that will bring trust to the system for consumers and others, it will allow us to see that the privacy expectations of consumers are respected, that states are aligned in policy, that we are aligning payment and other levers to advance and sustain a durable interoperable ecosystem, to make data more portable and liquid with tools like APIs, and to have a set of standards that allow more seamless, yet appropriate, sharing of electronic health information for “small” (individual patient), “big” (population level and beyond) and “long” data (wrapping around the individual and telling their health story over time).

We are thankful to our federal, state and private sector partners who have worked with us over these past few months to shape this path forward and help us to identify the most impactful actions to achieve a learning health system. To date, there have been contributions from over forty individuals and organizations, twenty-five federal partners, 90 individuals from 38 states and ONC’s Federal Advisory Committees (FACAs) whose membership includes 167 representatives from over 140 private and public organizations. The Roadmap identifies critical actions that should be taken by a wide range of stakeholders to help advance nationwide interoperability.

I invite you to review the Roadmap, provide your input and choose a critical action that you are willing to commit to, or even take the lead on. It is only through everyone’s combined efforts that we will achieve a learning health system that brings real value to electronic health information as a means to better care, wiser spending, and healthier people. This Roadmap is intended to be a living document owned and guided in its evolution by all health IT stakeholders.

Because the Office of the National Coordinator for Health IT (ONC) is charged with supporting the adoption of health IT and promoting nationwide health information exchange to improve health and care, it has played a major role in coordinating with a broad array of stakeholders to develop this initial draft. ONC will continue to support stakeholders by coordinating input and publishing future versions of the Roadmap. ONC is accepting public comment on this draft version of the Roadmap until 5 p.m. ET on April 3, 2015 on www.healthit.gov/interoperability. After carefully reviewing and integrating the public’s feedback, ONC will release an updated Roadmap later in 2015. ONC is also releasing an open draft of the 2015 Interoperability Standards Advisory that is an initial version of a “best available standards and implementation specifications” list for interoperability of clinical health information that enables priority learning health system functions 2 . Development of this list is identified as a critical action in the Roadmap that ONC has committed to. Please review this list and provide comments on www.healthit.gov/interoperability.

While you take time out to comment on these documents, please do not slow your work to advance interoperability. Thank you for your participation in this collaborative process. And thank you in advance for your thoughtful comments and willingness to take the lead on critical actions. It is a testament to the remarkable spirit of this nation’s health IT community and our shared interest in putting the person at the center.

Karen B. DeSalvo, MD, MPH, MSc National Coordinator for Health Information Technology 

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