On Friday, January 30, 2015, the Office of the National Coordinator (ONC) released two documents related to achieving greater health IT interoperability across the healthcare system. The Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Draft Version 1.0 document describes the actions and roles of a variety of health IT stakeholders needed to achieve the vision presented in ONC’s 10-Year Interoperability Concept Paper. ONC also published the 2015 Interoperability Standards Advisory, which is an “open draft” intended to begin an interactive process that will ultimately result in a list of standards and implementation specifications for a broad range of clinical health IT interoperability purposes. Both documents released today are open for public comment—stakeholders can submit comments on the Roadmap through April 3, and comments on the Standards Advisory are due by May 1.
The Roadmap is a 10-year plan which describes barriers to interoperability across the current health IT landscape, the desired future state that the industry believes will be necessary to enable a learning health system, and a suggested path for moving to the desired future state. In addition, the Roadmap lays out a path to achieving the vision in the three-, six- and ten-year timeframes and a vision to catalyze collaboration and action across government, communities, and the private sector. ONC envisions the Roadmap as enabling stakeholders to make key commitments and take actions that align with other stakeholder actions, in order for the nation to collectively move towards a learning health system.
The Roadmap focuses on actions 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. Although this near-term target focuses on individuals and care providers, ONC sees interoperability as useful to other areas, including community-based services, social services, public health, and the research community. Moreover, the Roadmap focuses on decisions, actions, and actors required to establish the best minimum level of interoperability across the health IT ecosystem, starting with clinical health information, in support of a learning health system.
ONC also identifies the four most important actions for public and private sector stakeholders to take to enable nationwide interoperability of electronic health information through health IT in the near term:
- Establish a coordinated governance framework and process for nationwide health IT interoperability
- Improve technical standards and implementation guidance for sharing and using a common clinical data set
- Enhance incentives for sharing electronic health information according to common technical standards, starting with a common clinical data set
- Clarify privacy and security requirements that enable interoperability
ONC also presented a timeline of select high-level critical actions for near-term wins that are outlined in Figure 1 below. ONC does note that the timeframes that it identifies are approximate estimates.
The 2015 Interoperability Standards Advisory will coordinate the identification, assessment, and determination of the best available interoperability standards and implementation specifications for industry use toward specific health care purposes. The 2015 Advisory’s scope focuses on clinical health IT interoperability, and does not include Health Insurance Portability and Accountability Act of 1996 (HIPAA)-related transactions.
The 2015 Advisory is an “open draft” designed to begin an interactive process that will ultimately result in a list of standards and implementation specifications for a broad range of clinical health IT interoperability purposes. ONC emphasizes this advisory is neither complete nor exhaustive and will remain that way throughout 2015, as industry dialogue continues on where disagreement exists regarding the best available standards as well as greater certainty and clarity on areas where widespread consensus exists.