ONC calls for interoperability by 2017

New roadmap proposes 'rules of engagement'
By Bernie Monegain
09:56 AM
illustration of connected lines

The Office of the National Coordinator released this morning a draft roadmap, along with proposed actions to take in order to achieve interoperability and a learning healthcare system in the next two years.

The document, Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Draft Version 1.0 outlines steps "that will 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."

The "time has come for us to be more explicit about standards," said ONC Chief Karen DeSalvo, MD, in a Jan. 30 press call detailing the roadmap, a 150-page plus document addressing everything from governance, standards and certification to privacy and security. "Health IT that facilitates the secure, efficient and effective sharing and use of electronic health information when and where it is needed is essential to better care, smarter spending and a healthier nation," DeSalvo said.

ONC is accepting public comments and key commitments on the draft Roadmap for approximately 60 days, which will end at 5 p.m. ET on April 3, 2015.

The roadmap builds on the vision ONC outlined in Connecting Health and Care for the Nation: A 10 Year Vision to Achieve An Interoperable Health IT Infrastructure.

In her letter at the start of the roadmap, DeSalvo emphasizes that several action steps will be needed on the road to interoperability. The works, she writes, will occur along three critical pathways:

  1. Requiring standards;
  2. Motivating the use of those standards through appropriate incentives; and
  3. Creating a trusted environment for the collecting, sharing and using of electronic health information
Although there have been several interoperability success stories on a regional or organizational level, as Erica Galvez, ONC's interoperability and exchange portfolio manager, pointed out in the Jan. 30 ONC call, the "reality is none of those efforts to date have scaled to the level we need," she said: And that's "interoperability on a nationwide scale."
Among the areas the interoperability roadmap covers, as Galvez highlighted, are addressing not only vocabulary, security and transport standards but also resource location. Moreover, regarding certification, in the roadmap, there's a "focus on the need for testing tools beyond certification programs," Galvez said. 
On the privacy and security front, the roadmap calls for "additional education" to educate stakeholders that have been misinformed about HIPAA and federal data privacy laws. 
And for governance? "ONC is clearly committing to establishing a governance framework," she added. And this includes establishing a clear set of rules and holding organizations accountable. 

Overall, as DeSalvo added, the roadmap "will require us to agree to a set of rules of engagement that will bring trust to the system for consumers and others."

It will allow us to see that the privacy expectations of consumers are respected, that states are aligned in policy, that we are aligning payment and other levers to advance and sustain a durable interoperable ecosystem, to make data more portable and liquid with tools like APIs, and to have a set of standards that allow more seamless, yet appropriate, sharing of electronic health information for 'small' (individual patient), 'big' (population level and beyond) and 'long' data (wrapping around the individual and telling their health story over time)."

Healthcare IT News Managing Editor Erin McCann contributed to this story.