Interoperability

Interoperability describes the extent to which systems and devices can exchange data, and interpret that shared data.

Auto bumpers and HealthIT Interoperability

Ralph Nadar's book Unsafe At Any Speed raised public awareness of some of the safety problems associated with the Chevrolet Corvair.  Nadar’s book, however, was also an indictment of the auto industry as a whole and served as a lightning rod for legislation establishing what would eventually become the National Highway Transportation Safety Administration (NHTSA). 

These two industries, HealthIT and automobiles have quite a lot in common including that they are both highly regulated.  These regulations exist because in both industries poor design can lead to safety issues and the possible death of their user’s.

Interoperability takes Center Stage at Health IT Committee Meeting

Connected computers to represent interoperability in healthIT

The Office of the National Coordinator for Health IT shared "early strategic elements" of a draft 10-year roadmap for achieving an interoperable health IT infrastructure, Health Data Management reports (Slabodkin, Health Data Management, 10/16).

In June, ONC released a paper outlining health IT interoperability goals the agency hopes to achieve over a three-, six- and 10-year time period (iHealthBeat, 6/5).

The agency plans to release a final version of its 10-year national interoperability plan by the spring (Conn, Modern Healthcare, 10/15).

The updated draft roadmap was presented at a joint meeting of the Health IT Policy and Standards committees by ONC's Interoperability and Exchange Portfolio Manager Erica Galvez.

During the meeting, Galvez said ONC has adopted the Institute for Electrical and Electronic Engineers definition of interoperability, which calls for a system or product to work with other systems or products without special effort on the consumer's end.

She said that the draft report, which will be available for public comment in January 2015, takes an incremental approach to achieving interoperability (Health Data Management, 10/16). The draft report states:

  • By 2017, providers and patients should be able to send, receive, find and use basic electronic health information;
  • By 2020, providers and patients should be able to contribute to and access their health information at a granular level and seamlessly use remote monitoring devices;
  • By 2024, patients should be able to regularly track and share data from mobile and medical devices electronically, and providers should have increased longitudinal information to contribute to a learning health system (ONC draft report, 10/15).

According to the draft report, ONC will create and launch a program that monitors who complies with the voluntary national framework (Bowman, FierceHealthIT, 10/14).

During her presentation, Galvez also touted the nation's existing interoperable system, noting, "There is a base from which we can build. We're not starting from zero."

For example, she noted that health care organizations have increased the number of directed exchange transactions through health information exchanges by 225% to more than 226.6 million transactions between the second quarter of 2012 and the fourth quarter of 2014 (Modern Healthcare, 10/16).

Overall, committee members generally agreed with the draft roadmap (Gold, PoliticoPro, 10/15).

In addition, the Health IT Now Coalition in a statement applauded ONC for a plan that "immediately challenges the status quo to think beyond pecuniary interests to transforming health care."  Health IT Now Coalition Executive Director Joel White said the Policy and Standards committees must "step up," take charge and demand better outcomes for consumers (Health Data Management, 10/16).

Committees Approve Several JASON Task Force Recommendations

Also on Wednesday, the Policy and Standards committees formally approved a set of six recommendations from the JASON task force that calls on CMS to focus efforts on public application programming interfaces, Clinical Innovation & Technology reports (Pedulli, Clinical Innovation & Technology, 10/16).

The JASON task force was created as a short-term joint workgroup under the Policy and Standards committees to analyze and synthesize feedback on a previously released JASON report, which was prepared by an independent group of scientists that advises the federal government on issues pertaining to science and technology (iHealthBeat, 9/4).

In a final report, the JASON task force recommended using Stage 3 of the meaningful use program as a "pivot point" to begin the transition to public APIs (Durben Hirsch, FierceEMR, 10/14).

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of EHR systems can qualify for Medicaid and Medicare incentive payments.

Specifically, the committees approved recommendations to:

  1. Focus on interoperability by realigning the meaningful use program and initiate adoption of public APIs;
  2. Create a coordinated industry-based exchange architecture to support API-based interoperability;
  3. Create nationwide data sharing networks;
  4. Enable the public API to allow data- and document-level access to clinical and financial systems;
  5. Develop priority API Services; and
  6. Have ONC monitor the progress of adopting APIs and implement non-regulatory steps to assist with the adoption (Sullivan, Government Health IT, 10/15).

According to Healthcare Informatics, the committee members did not approve language that would encourage CMS and ONC to delay or stagger Stage 3 of the meaningful use program (Raths, Healthcare Informatics, 10/15).

The Policy and Standards committees will draft a letter to ONC and CMS formally endorsing the task force's recommendations (Clinical Innovation & Technology, 10/16).

Source: iHealthBeat, Thursday, October 16, 2014