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ONC Report on Health IT Details Barriers to Interoperability

News  |  By HCPro Staff  
   March 16, 2016

Although some progress has been seen, a lack of health IT vendor transparency and cooperation have been named as barriers to interoperability in the ONC’s annual report.

A version of this article originally appeared on

The Office of the National Coordinator of Health IT has published its annual report to Congress detailing the ups and downs of health IT in 2015 and plans for 2016. The report summarizes actions taken by various government agencies to advance health IT, such as the Department of Health and Human Services’ Federal Health IT Strategic Plan, the ONC’s Interoperability Roadmap, and CMS’s EHR Incentive Programs, and touches on the pivotal role private-sector industry plays in realizing the goals outlined in the report. 

The report identifies three critical areas that the ONC and all departments of HHS will focus on for 2016:

  • Interoperability
  • The security and usability of health IT
  • Simplifying health IT incentive program requirements and creating clear links between participation and positive outcomes

Some progress was made in the area of interoperability, according to the report. The ONC launched a number of initiatives over the past year to promote interoperability and chip away at obstacles to its realization, including grant award programs such as the Community Health Peer Learning Program.

Roughly a quarter of hospitals reported that they engaged in all four interoperability functions (finding, sending, receiving, and using electronic health information) in the joint ONC and American Hospital Association’s 2014 Annual Survey Information Technology Supplement. 

Interoperability, however, faces significant barriers. Although the report touts the overall success of the EHR incentive programs, it acknowledges that, in part due to the limited types of healthcare providers eligible to participate in the programs, there are limitations to its benefits. A study published in the March issue of Health Affairs points out that EHR adoption among ineligible hospitals and providers, including long-term care, rehabilitation, and psychiatric hospitals, lags significantly.

This disparity means that a patient’s records don’t travel seamlessly across the healthcare system and those gaps in information can lead to poor care coordination, escalating costs, and other quality and safety issues, according to Daniel Walker, PhD, MPH, the study’s lead author. The ONC’s report draws similar conclusions about the unequal state of health IT adoption across the healthcare continuum. 

The lack of health IT vendor transparency and cooperation are also named as barriers to interoperability. The report calls for the ONC to be given greater jurisdiction to require vendors to disclose detailed information about their products. The report also says that the strict non-disclosure provisions in vendor’s licensing agreements prevent users from sharing important information about a product’s usability and security. A proposed rule announced March 1 would give the ONC direct oversight of health IT certification, including the power to review and terminate certification.

Despite a number of high-profile security breaches, the privacy and security of health IT saw some support in 2015 through the 2015 Edition final rule of the ONCs Health IT Certification Program. Improvements in the 2015 Edition include new data segmentation criteria that allows providers to flag certain sensitive information, such as substance abuse and behavioral health information, for additional protection while still including it in the appropriate data stream. However, 2015 also saw large-scale breaches that affected more than a hundred million Americans.

Cybersecurity continues to be a challenge to health IT, and efforts to address it will be an on-going concern in 2016.

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