ONC Unveils Final Interoperability Roadmap

The ten-year roadmap is similar to the draft released in January for public comment, but clarifies how technical standards are to be improved so that health data can be stored in a manner conducive for sharing among providers and patients.

The Department of Health and Human Services' Office of the National Coordinator for Health Information Technology released on Tuesday the final roadmap for electronic health information interoperability.

ONC officials in Washington, DC, presented the 10-year plan stressing "sameness," standards, and compatibility" via teleconference. "The roadmap is about action. It's not just about talking, it's not just about planning. It's about doing," said Erica Galvez, interoperability portfolio manager for ONC, describing how the federal agency intends the country's goals for health data sharing and interoperability to be achieved.

The document outlines a timeline for three implementation stages, each with its own overarching goal:

"By putting out this document today, the federal partners are saying these are the three big overarching commitments that we're making. This roadmap provides more specificity in how we're going to get to that place," said Karen B. DeSalvo, MD, national coordinator for health IT.

The roadmap is similar to the draft released in January for public comment, but clarifies how technical standards are to be improved and offers implementation guidance for priority data domains.

ONC identifies "four critical pathways" it says stakeholders should take toward storing health data in a manner suitable for sharing among providers and patients:

• Improve technical standards and implementation guidance for priority data domains and associated elements. In the near-term, the Roadmap focuses on using commonly available standards, while pushing for greater implementation consistency and innovation associated with new standards and technology approaches, such as the use of APIs.
• Rapidly shift and align federal, state, and commercial payment policies from fee-for-service to value-based models to stimulate the demand for interoperability.
• Clarify and align federal and state privacy and security requirements that enable interoperability.
• Coordinate among stakeholders to promote and align consistent policies and business practices that support interoperability and address those that impede interoperability

DeSalvo mentioned the importance of eliminating "information blocking" among vendors and providers, on the call, which she says impedes interoperability. "Different stakeholders across different ecosystems will have to do things in the same way—or in a compatible way." But the phrase appears only once within the 94-page document.

Providers and the Private Sector
DeSalvo said that the final version of the roadmap was developed with input from the private sector. "We're going to really call in on the private sector to continue the work they're already doing, and to work hand-in-hand with us."

The Best Interoperability Game in Town

DeSalvo said providers may expect greater fluidity of data, so that records will be available from any provider a patient has visited. "Anything we can do to unblock data today and address interoperability is the kind of tangible change [providers] will feel, and… we believe that where there is data that can move, it should move."

In a statement issued late Tuesday, Bruce Siegel, president of America's Essential Hospitals, said, "The administration's interoperability roadmap moves us closer to the promise of the electronic health record. We agree with its three core commitments and will review the draft standards closely."

"Essential hospitals care for low-income and other vulnerable patients, who often face social and economic roadblocks to health care access and information: poverty, homelessness, language barriers, and low health literacy, for example," he continued. "It will be important to consider their needs and challenges to their care as we work toward an EHR that improves health care for all people."

Blair Childs, senior vice president of public affairs at Premier, Inc. said ONC's roadmap is "a significant leap forward in the national effort driving toward interoperability…We look forward to working with the administration to advance the technical standards, certification requirements, privacy/security standards and other initiatives that will enable true HIT interoperability. "

The roadmap, said DeSalvo, "describes what the federal partners see needs to happen by when, and by whom… It clearly spells out what we believe we can do." ONC will also ask stakeholders from the private sector to make a commitment to the plan at a public-facing event within the next week.