ONC unveils Interoperability Roadmap for public comment

The Office of the National Coordinator for Health IT has released for public comment its shared nationwide roadmap for interoperability.

The roadmap's goal is to provide steps to be taken in both the private and public sectors to create an interoperable health IT ecosystem over the next 10 years, according to ONC.

One of the main focuses on the roadmap, which spans more than 140 pages, is to enable "a majority of individuals and providers across the care continuum to send, receive, find and use a common set of electronic clinical information at the nationwide level by the end of 2017." 

"We look forward to doing this in partnership with the private sector ... and we believe that by going forward together and holding each other accountable, that we're really going to get to a place where we have the information necessary to see that we have better care, that we can have smarter spending, and healthier people in the country," National Coordinator Karen DeSalvo said during a call on the roadmap.

The roadmap is also linked with President Barack Obama's recently introduced Precision Medicine Initiative, which aims to increase the use of personalized information in healthcare, ONC announced. On Friday, Obama announced that he will request a budget of $215 million toward the initiative, FierceHealthcare reported. 

"HHS is working to achieve a better healthcare system with healthier patients, but to do that, we need to ensure that information is available both to consumers and their doctors," HHS Secretary Sylvia M. Burwell said in the announcement. "Great progress has been made to digitize the care experience, and now it's time to free up this data so patients and providers can securely access their health information when and where they need it."

To hold organizations accountable, Jodi Daniel, ONC's director of the Office of Policy Planning, said the agency currently is exploring all governance options. "We are considering regulatory options; we're considering how we can leverage certification to ensure accountability with the rules of the road; we're looking at how best we can ... hold people accountable for meeting the principles," she said during the call.

DeSalvo also noted that included a recent conversation about payment models, particularly HHS' recent announcement that it will reform how it pays providers for treating Medicare patients in the coming years. "We have heard from private payers and we are certainly interested in talking through how our payment models can support and advance HIT and interoperability," the National Coordinator said. "These are related and completely tied efforts to have that better payment model and require better data to be unlocked so it can be put to use to assess value, and at the same time the payment models need to reinforce that there must be data standards that we all agree to."

Regarding privacy, Erica Galvez, ONC's Interoperability Portfolio Manager, said during the call that while there are many different policies, state-level laws and federal laws that apply to the sharing of health information, "there has been clearly a number of misinterpretations or misunderstandings of our federal framework provided through HIPAA for health information sharing." Because of that, the roadmap calls for additional education to advance understating across the national of the federal policy framework, she said.

It also calls for "some harmonization" for state and organizational level policies that apply to information sharing, Galvez said. That harmonization will help make it easier for individuals to understand their choices related to their health information, which is currently complicated because of the many different definitions of data categories and rules around how information can and should be shared, she said.

Along with the roadmap, ONC also released a draft of 2015 Interoperability Standards Advisory, which "represents ONC's assessment of the best available standards and implementation specifications for clinical health information interoperability as of December 2014."

An updated standards advisory will be released every December--"a standards stocking stuffer, so to speak"--Steven Posnack, director of the Office of Standards and Technology, said during the call. The advisory is non-regulatory in nature, he added.

"It is designed to be a interactive process that will ultimately result in an annual list of standards and implementation specifications for a broad range of clinical health IT interoperability purposes," Posnack said. "It's really intended to be an all-hands-on-deck experience for the ONC, federal partners and everyone out in the industry." 

The roadmap is garnering praise from industry leaders, including from the College of Healthcare Information Management Executives. CHIME said that it "welcomes" the Interoperability Standards Advisory today as part of the roadmap.

"This is a much-needed playbook for each and every health IT professional," CHIME President and CEO Russell Branzell said in an announcement. "Now, healthcare providers and health IT developers have a single source of truth, with an extensible process to align clinical standards towards improved interoperability, efficiency and patient safety. While we have made great strides as a nation to improve EHR adoption, we must pivot towards true interoperability based on clear, defined and enforceable standards."

Debra L. Ness, president of the National Partnership for Women & Families, also praised the roadmap, calling it a "very welcome, very promising, and very smart next step." She also applauded the roadmap's goal of focusing on interoperability not just among providers, but also patients and their caregivers.

The draft roadmap stems from, and is a more robust version of, a vision paper published in June by ONC. The ultimate goal of ONC in developing the road map is to build a continuous learning health system. The interoperability roadmap is also part of the ONC's overarching Federal Health IT Strategic Plan, which spans from 2015 to 2020.

"As a draft, this roadmap needs the input from knowledgeable, engaged stakeholders and, in particular, areas where important actions or milestones may be missing," according to ONC.

Comment on the draft interoperability roadmap are due by April 3; comments on the standards advisory are due in by May 1. 

To learn more:
- here's the roadmap (.pdf)
- check out the Interoperability Advisory Standards (.pdf)
- read the announcement