ONC unveils 10-year plan for healthcare interoperability

By 2024, the national health IT infrastructure and data standards will evolve to support robust information sharing and aggregation, creating a "continuous learning" environment for care, according to an ONC paper published today.

The Office of the National Coordinator for Health IT outlined a 10-year plan to develop an interoperable health IT ecosystem that can simultaneously improve population health, boost patient engagement and lower costs.

The agency shared a set of five "critical building blocks" for achieving its goals, while also revealing its expectations for three, six and 10 years down the road.

National Coordinator for Health IT Karen DeSalvo (pictured), at the Patient Privacy Rights Summit in the District of Columbia on June 4, talked about the importance of getting feedback from multiple stakeholders for the paper, published in the wake of ONC's recently announced realignment, which aims to streamline processes as federal funding dries up.

"Though at ONC we have set interoperability to connect care and information on behalf of patients and consumers as a high priority ... I want to make sure that it's clear to folks that we didn't do that in our box at Humphrey," DeSalvo said. "We spent the first few months doing quite a bit of informal ... and formal environmental scans, looking for what kinds of writings, letters, comments we were receiving from our stakeholders of all walks." 

While the current health system has the capability to capture data at rest and in silos, DeSalvo said, to really make it powerful, it needs to be able to move safely and securely for the benefit of people.

"Interoperability ... is so complex," she said. "It requires all of us to have some shared responsibility thinking through how we're going to get there in a way that meets everyone's needs and expectations."

Within three years, according to ONC, the agency will have developed an interoperability roadmap by scaling current health information exchange approaches "across vendor platforms" to support transitions of care and public health. ONC said it plans to focus heavily on query-based data exchange and point-to-point information sharing.

Three years later, ONC said it anticipates "enhanced interoperability" throughout the care delivery system. Care providers from various settings, including schools and prisons, will be able to share relevant health information when and how they need it, the agency says. What's more, ONC said that disparate information sources, such as multi-payer claims databases and clinical data registries, will be increasingly integrated.

For instance, in one use-case example, ONC said that clinical settings and public health will be connected via bi-directional interfaces that allow for both reporting to public health departments and feedback and decision support to providers from public health entities.

By year 10, ONC said it envisions patients managing their own care information using personal electronic devices, sharing that information across multiple platforms with multiple parties, as necessary.

The building blocks necessary to achieving its goals, according to ONC, include:

  • Core technical standards and functions
  • Certification for adoption and optimization of products and services
  • Privacy and security protections
  • Supportive business, clinical cultural and regulatory environments
  • Governance

"It will take time to build a fully interoperable infrastructure of coordinated care and communication across healthcare providers, patients and public health entities that improves healthcare quality, lowers healthcare costs and improves population health," the paper's authors said. "No one person, organization or government agency alone can realize this vision of an interconnected health system."

To learn more:
- read the paper (.pdf)