With final interoperability roadmap, ONC aims to put plans into action

The Office of the National Coordinator for Health IT on Tuesday published the final version of its interoperability roadmap, a document that National Coordinator Karen DeSalvo called the culmination of "six years of success in adopting electronic health records," as well as of actions on the part of the federal government.

The final roadmap looks similar to the draft version published in January. For instance, the goals outlined for three, six and 10 years out remain the same, according to ONC Interoperability Portfolio Manager Erica Galvez, with an overarching goal of achieving a learning health system.

DeSalvo (pictured) noted that the final roadmap is made up of three broad components:

  1. Drivers: "We need to have the right business case or set of economic incentives to create not only the push, but the pull of data," she said. "We want to see that providers are incentivized to share data to follow patients across the care continuum and have their information follow them." Positive drivers include the Department of Defense's electronic health record acquisition, while negative drivers include prevention of certain kinds of behaviors, such as information blocking.
  2. Policy and technical components: These include elements such as patient matching and privacy and cybersecurity expectations, according to DeSalvo. They also include rules of the road: "We want to see that we're creating a trust environment that governs that data," she said.
  3. Outcomes: DeSalvo stressed, as she previously did when talking about the updated federal health IT strategic plan, that all of these efforts are about putting the consumer at the center. "This needs to lead us to a place where exciting changes in medicine like precision medicine touches everybody in this country with equity," she said.

Galvez said the roadmap represents action for everyone involved.

"It's about doing; it's not just about planning," she said. "The term 'action' is used 107 times in the document."

For instance, with regard to privacy, DeSalvo pointed out that ONC will be working with the National Governors Association (NGA) on a process that would give an assessment of states' individual privacy laws and expectations, and of model practices or ways that information can move across state lines.

"What we have to do is create a trust environment with respect to consumer expectations about data sharing and use," she said. Efforts, therefore, must be harmonized across state lines as much as possible, DeSalvo added.

What's more, she said, such efforts also are about ensuring that no unreasonable data blocking is taking place.

"It's not as much about interoperability as it is about making the systems easier to use," she said. "Once we make the systems more friendly, better data goes in, better data can move across the transit."

ONC previously worked with NGA on information exchange efforts; in 2009, the latter published a report on preparing to implement the Healthcare Information Technology for Economic and Clinical Health (HITECH) Act.

Jodi Daniel, outgoing director of ONC's Office of Policy Planning, said of revisiting efforts with NGA that the time was right to jump back in.

"Sometimes you have to make some progress on something, let it sit for a while, and then pick it back up when the time is right and people have had time to stretch out," Daniel said. "I think the time is right now. There is data, there is flow of information ... the fact that we tried before and made some progress ... we have a place to build from. Change often happens incrementally."

To learn more:
- check out the roadmap (.pdf)
- here's the 2009 NGA report (.pdf)