The nation’s leading health IT groups offered a range of responses to the Proposed Interoperability Standards Measurement Framework published by the Office of the National Coordinator for Health IT in May.
Broadly, most groups expressed some trepidation that any new standards would cause undue burden to providers, and urged the ONC to focus efforts on measurement areas that will have the biggest impact.
The ONC’s framework focused on two key issues in measuring EHR interoperability across the country: standards implementation and how end users can customize those standards to meet their needs.
Below is a brief summary of each organization’s commentary.
- AMIA: American Medical Informatics Association expressed (PDF) support for the ONC’s framework, but urged the agency to target “high-value standards,” pointing specifically to functionalities for accessing drug databases and transmitting laboratory data. AMIA also wants the measurement framework to be as automated as possible, noting that easier reporting mechanisms will translate to higher participation rates.
- HIMSS: The organization agreed (PDF) that measurement is “critical” to improving interoperability, but cautioned the ONC to ensure the measurement framework “will not produce undue burden on the industry." That issue could be mitigated by tapping into existing reporting frameworks. HIMSS also pushed for standards to be a means to interoperability and not the end goal and urged ONC to include a broad range of stakeholders, including government agencies that hold house important data like the Centers for Medicare and Medicaid Services and the CDC.
- EHRA: The Electronic Health Record Association (a sub group of HIMSS) advocated (PDF) for a broad approach to measuring interoperability by addressing standardized approaches in conjunction with non-standard methods. Like AMIA, EHRA pushed ONC to focus on use cases that will make the biggest impact, while acknowledging the potential burdens on providers.
- CHIME: The College for Health Information Management Executives offered more resistance. The group pointed (PDF) to patient matching as one of the biggest hurdles to interoperability and called the measurement standards "premature." CHIME pushed the ONC to focus on developing standards for seamless communication between IT systems, ensuring data exchange identifies patients “with 100% certainty” and making data exchange usable for clinicians before tackling interoperability standards. CHIME said that if ONC moves ahead with the measurement framework, the agency should work with industry partners to prioritize certain cases and develop a “granular set of standards.”
- Health IT Now: Acknowledging that measuring interoperability is necessary, Health IT Now cautioned (PDF) that a narrow focus on successful data transmissions “will devalue actual improvement on use of data in improving care and allow the mere capability to exchange information to remain the future goal for health systems.” The group also pushed for collaboration from private sector organizations that can “lead the charge in identifying, developing, and deploying standards to achieve interoperable systems” as well as more involvement from patients and patient advocates.