AHA, HIMSS weigh in on ONC interoperability plans

'Whether the standards work will only be proven through successful use in clinical care'
By Jack McCarthy
10:29 AM

The Office of the National Coordinator for Health IT's 2016 Interoperability Standards Advisory in its public comment period has drawn some criticism from industry groups, which say the draft needs more detail and clarity.

Through the advisory, ONC hopes to develop the "best available" interoperability standards and implementation specifications for industry use to fulfill clinical health IT interoperability needs. The public comment period ended Friday, and the input will be considered in a final 2016 Advisory by the end of 2015.

The advisory's scope includes electronic health information created in the context of treatment and subsequently used to accomplish a purpose for which interoperability is needed, such as a referral to another care provider or public health reporting.

The advisory used six characteristics to determine whether a standard is the "best available" These characteristics are adoption level, cost, implementation maturity, regulation, standards process maturity, and test tool availability.

Both the American Hospital Association (AHA) and the Healthcare Information and Management Systems Society (HIMSS), owner of Healthcare IT News, weighed in with some criticism of the draft.

AHA input
AHA urged ONC to provide greater detail about the characteristics and metrics used to assess the standards identified as the "best available" in the advisory.

Supplementing the six characteristics with detailed information on the use of the standards in a real world environment "will indicate how each standard was evaluated and achieved the designation," Ashley Thompson, AHA vice president and acting senior executive for policy, noted in a prepared statement.

In addition, AHA recommended that ONC publish all testing results that show how the standards support the use cases referenced in the advisory, and increase educational support to providers on these standards.

"ONC may apply the designation of 'best available' to standards, but whether the standards work will only be proven through successful use in the provision of clinical care," AHA explained.

HIMSS comment
HIMSS said that, in general, it supports the way in which the content is organized and presented in the draft advisory. In its comments, signed by HIMSS Chair Dana Alexander and CEO Stephen Lieber, HIMSS said the draft may be oversimplifying a complex topic and ONC should modify its definition for interoperability maturity levels.

"HIMSS would like to emphasize that standards maturity is not a two dimensional concept (in the case of the Interoperability Standards Advisory, either "draft" or "final")," HIMSS wrote in its comments. "There could be risks in trying to reduce it to such that could overly simplify a complex or nuanced topic."

HIMSS recommended the ONC better articulate standards maturity in future versions of the advisory by considering whether the proposed standard are being developed to advance new technologies, whether  it is a competing standard for an existing standard that is currently adopted, and whether the proposed standard is an update of an existing standard that has achieved broad adoption.