ONC releases comments on its draft interoperability roadmap

The final tally is in--nearly 250 comments were submitted on the Office of the National Coordinator for Health IT's draft interoperability roadmap, an impressive number for a document that was not part of formal rulemaking.

Not surprisingly, the comments varied depending on the type of commenter. Many supported the roadmap's goals in theory but had concerns about its real world applicability and/or practical suggestions for improvement. Cerner called the roadmap a "well-organized and comprehensive approach" and appreciated ONC's "super-human" efforts to obtain feedback; the vendor provided nine pages of specific suggestions to improve the roadmap. Some groups, such as Health IT Now, used the comments as an opportunity to express concern that the Meaningful Use program was not meeting its goals. Health IT Now also worried that the roadmap was "too ambiguous."

Many commenters, including most consumers and consumer groups, were concerned about inadequate privacy and security safeguards, with some opposed to the roadmap itself for this reason, which was not lost on others commenting.

For instance, Zack Gill, a "private citizen," wrote: "I am opposed to the medical records tracking system. It threatens the privacy of every person. Subjects our medical records to the risk of hacking. Interferes with the rights of states to make their own laws and regulations regarding medical records." Matthew Rafalski, M.D., from the Dasypring Family Health Center, noted that "more than poor infrastructure and lack of electronic education, we need a culture change in order to even see the importance of electronic access and exchange of information in the public realm."

The lack of interoperability among EHRs has been a point of contention in recent months. Stage 3 of the Meaningful Use program requires interoperability, as does the newly enacted Medicare Access and CHIP Reauthorization Act, which calls for interoperability by 2018. In the meantime, public/private partnerships such as Carequality and CommonWell aren't waiting for direction from ONC and are taking their own steps to improve data sharing among EHR systems.

The roadmap's goal is to create steps to achieve health IT interoperability in the next 10 years. Comments on the roadmap closed April 3. The final roadmap is expected later this year.

To learn more:
- read the comments