February 3, 2015 | by Pamela Tabar

ONC targets interoperability standards and data exchange

The Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology (ONC) has released a new roadmap of actions to advance the country’s healthcare data-sharing and interoperability missions.

The roadmap, Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Version 1.0, is part of the ONC’s 10-year plan to achieve a national healthcare information infrastructure, using health information technology (IT) to deliver healthcare more efficiently and cost-effectively.

Using incremental agendas for the next three years, the next six years and the next 10 years, the roadmap’s key near-term priorities include the development of a trusted platform for collecting and exchanging electronic health information and the implementation of standards to gather and share the data.

Exchange activity

Measuring exchange activity allows us to assess whether information is flowing in an interoperable manner.

Measures of exchange activity should provide insight to:

  • Volume: whether and how much information is being exchanged;
  • Penetration: who is exchanging information across the care continuum;
  • Information type: what types of essential electronic health information are being exchanged and for what purpose or use case;
  • Geographic reach: where information is exchanged (for instance, nationwide versus pockets of the country);
  • Organization/System boundaries: whether and the extent to which information is flowing across systems and organizational boundaries;
  • Exchange mechanisms: how information is exchanged to identify the services, policies and technologies (for instance, standards, infrastructure) that enable exchange and interoperability including technology infrastructure, standards, programs and policies that support capabilities to engage in interoperable exchange; and
  • Person-centric: Exchange occurs when an individual requests it.

Source: Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Version 1.0

The ONC has previously identified long-term care as one of the populations whose inclusion is vital to the success of cross-continuum interoperability efforts. The new roadmap also puts long-term care among the care delivery groups to be given focus early on. In the near-term, measurements “will be focused on certain populations, such as office-based physicians, hospitals, individuals and long-term care and behavioral health care providers,” the report states. “This reflects available data sources as well as the three-year agenda, which focuses on enabling the sending, finding, receiving and using of essential health information by individuals and providers along the care continuum.”

Beginning to collect data now will help the ONC to improve the measurements and benchmarking down the road. “Initially, ONC will focus measurement on the domains related to interoperable electronic health information exchange capability, information flow and use and to a lesser extent, impacts,” the report states. “Over time, there will be a shift to defining success in terms of how use of information exchanged in interoperable health IT improves outcomes and supports a learning health system.”

The roadmap also takes a harder look at what interoperability means—deeper and more specific parameters by which providers—and their EHR vendors—will be measured. The plan proposes several ways to evaluate the level and extent of exchange, including how timely the data is delivered and what entities at a facility or health system are actively exchanging information. [See table]

The draft roadmap is under a public comment period until April 3.

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