Taking out interoperability hurdles

DeSalvo: 'The country is waiting for us to get interoperability right.'
By Tom Sullivan
09:51 AM
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Karen DeSalvo, MD

The Office of the National Coordinator for Health IT has been reshaping itself for the future and is working on its strategic plan alongside a 10-year roadmap for interoperability — and that is against the backdrop of health IT reports put out by other federal entities, notably JASON and PCAST.

In all the efforts interopeability is critical.

Documents from JASON, conducted by independent scientists at The MITRE Group advising the Agency for Healthcare Research and Quality, and the President’s Council of Advisors on Science and Technology delve into health infrastructure and information exchange, essentially pointing to what needs to be done.

ONC’s HIT Policy Committee established a JASON Report Task Force and on Wednesday, co-chair Micky Tripathi suggested, among other things, that ONC cross-reference both PCAST and its own ONC Interoperability Roadmap when deciding how to move forward.

“Interoperability doesn't just happen,” said Tripathi, who is also CEO of the Massachusetts eHealth Collaborative. “It gets done for very specific use cases as we’ve seen.”

[Read more about Tripathi's take on interoperability in this Q&A: Interoperability: supply and demand.]

Indeed, interoperability is such a complex and weighty matter that national coordinator Karen DeSalvo, MD said ONC is charting a distinct course toward that end.

“Within the Federal Health IT strategic plan, interoperability is one of those key strategic areas,” DeSalvo said. “The interoperability work will fold back into the plan eventually.” 

Whether that will happen 10 years from now, when the nation reaches ONC’s interoperability goal, or sooner remains to be seen. In the meantime, DeSalvo explained that ONC plans to preview drafts of the interoperability roadmap at the joint HIT Policy Committee and HIT Standards Committee meeting in October, followed by a draft of the Federal Health IT Strategic Plan in December.

Both will be open to public comment and during the winter of 2015 ONC will do what DeSalvo called “some integration work” before publishing final documents.

The overarching idea is to enable interoperability and exchange in the short-run that also meet long-term goals, DeSalvo added. 

Whereas ONC has been criticized for plotting a 10-year course, members of the HIT Policy Committee said that the incentives for exchanging health data are changing as the industry shifts from fee-for-service to accountable care and population health management.

“When you think about sharing data, economics are going to drive behavior,” said Charles Kennedy, CEO of accountable care solutions at Aetna. “But the use cases associated with this are still very much in their infancy.”

And Cerner CEO Neal Patterson added when it comes to fueling interoperability, meaningful use is the biggest lever ONC has right now.

“It seems like to me that meaningful use Stage 3 is the last train leaving the station,” Patterson said. “We have to look as hard as we can to get as much as possible on that last train. It's a huge responsibility to miss that train.” 

Acknowledging Patterson’s train analogy, HIT Policy Committee vice chair Paul Tang explained that interoperability is “an extremely important focus” for ONC in the coming months and years — and in addition to the technical aspects there are the cultural, legal, privacy and social pieces.

“I know it’s hard to keep up with the pace,” DeSalvo said, “but the country is waiting for us to get interoperability right.”

[See also: DeSalvo: Interoperability 'top priority'.]