ONC finalizes roadmap for interoperability

A nationwide interoperability roadmap released by the U.S. Department of Health and Human Services (HHS) in January outlines a set of critical actions healthcare players need to take between now and 2024 to get to a fax machine-free future.

Charged with coordinating health IT across the country, HHS’ Office of the National Coordinator (ONC) is asking industry stakeholders to submit comments about its interoperability roadmap by April 3.

The 166-page draft, “Connecting Health and Care for the Nation,” sets a 10-year course toward interoperability of electronic health records (EHRs) with an initial industry effort to send, receive, find and use a common clinical data set by 2017. Between 2018 and 2020, ONC wants to expand interoperable health IT and users. By 2024, the agency hopes to achieve what it calls a nationwide health learning system.

The industry needs to do four things to reach those goals:

• Establish processes toward nationwide interoperability;

• Improve technical standards and guidance for sharing and using a common clinical data set;

• Develop incentives for sharing information in common standard formats; and

• Clarify privacy and security standards in support of interoperability.

“It’s time to free up data so patients can have access to information whenever they need it across the care continuum,” HHS Secretary Sylvia Mathews Burwell told attendees at ONC’s annual conference in February.

In addition to introducing the draft roadmap, cheerleading and chastising industry efforts, the conference featured presentations from health information exchange players across the country working on interoperability projects.

Despite their efforts and optimism, these pioneers in health IT say that they need more support.

“There aren’t a lot of resources to pay for health information exchange,” said Brian Braun, chief financial and strategy officer for the Colorado Regional Health Information Organization, describing results of an ONC-funded project that covered the cost of bringing long-term care providers into the state’s health exchange network. “It will require a commitment from payers and the health system.”

In its final report on an 18-month project that connected nursing homes with hospitals and pharmacies in Minnesota for improved care transitions for residents, Stratis Health defined the challenges.

“Upon implementation of the project, the value of health information exchange was realized immediately by the skilled nursing facilities and pharmacy. The value was not immediately realized by hospitals,” the non-profit healthcare quality and innovation organization wrote.

Meanwhile, some providers who saw the value and the vision and made the switch to electronic record keeping are now back at square one, said Dominic Mack, executive medical director of Georgia Health Connect during his presentation on implementing health data exchange in underserved areas.

“Sixty percent of companies are switching vendors because they have bought into systems that don’t support interoperability,” Mack said.

After more than 10 years of trial and error, federal enforcement of patient privacy statutes, “meaningful use” incentives, advances in technology, and anecdotal evidence, the connection between EHR standards, privacy rules and improved healthcare has started to make sense. Getting there will take considerably more time.

Cassie M. Chew is a freelance writer in Washington, D.C.