Interoperability Odyssey: 2024

The final frontier….the search for healthcare utopia where your records follow you seamlessly across the continuum of care without incident. It seems to be fantasy, but that might be what the office of the Office of the National Coordinator for Health Information Technology came out with a paper and a call for collaboration among stakeholders to share with them ideas and suggestions that would help in the achievement of this goal of interoperability over the next decade and the road beyond.

In their vision of the future, they want individuals, healthcare providers, communities, and healthcare researchers to be able to have many healthcare IT products and services that are interoperable and allow the healthcare system to learn on a continuous basis and be able to move the goal of “improved health care.” Patient engagement between care provider and patient would be constant and patients would be well informed as to their care roadmap and be able to be partners in their wellness.

I was excited on the encouraging news in that all 50 US states have a sort of health information exchange and that 50% of hospitals can electronically search for patient information from sources beyond their own organization and over 50% of office-based professionals and more than 80% of hospitals “are meaningfully using electronic health records which will require them to electronically exchange standardized patient information to support safe care transitions.”

In how they envision the nation getting there, they mentioned their focus on certain “Guiding Principles” for the future of the “health ecosystem, namely:

  1. Build upon the existing health IT infrastructure.
  2. One size does not fit all.
  3. Empower individuals.
  4. Leverage the market.
  5. Simplify.
  6. Maintain modularity.
  7. Consider the current environment and support multiple levels of advancement.
  8. Focus on value.
  9. Protect privacy and security in all aspects of interoperability.

The document followed up with a focus on a 3 year agenda with the paragraph titled “Send, Receive, Find, and Use Health Information to Improve Health Care Quality” that discussed  the development of an “interoperability roadmap as articulated in HHS Principles and Strategy for Accelerating Health Information Exchange.” The focus was on ensuring that the population as well as healthcare providers leveraged the basic set of health information across the continuum of care so that care coordination is enhanced and give us the ability to improve the quality of care.

It continued with a 6 year agenda that covered, aside from what was in the 3 year agenda, such things as a “multi-payer claims databases, clinical data registries, and other data aggregators will incrementally become more integrated as part of an interoperable technology ecosystem“.

Finally, in the 10 year agenda to take us to 2024, 4 building blocks are envisioned on how we achieve a state of initial interoperability:

  1. Core Technical Standards and Functions
  2. Certification to support adoption and optimization of Health IT products and services
  3. Privacy and security protections for health information
  4. Supportive business, clinical, cultural, and regulatory environment

In addition, it mentions a focus on data quality and reliability as part of the foundations for interoperability. The ability to engage with stakeholders and focus on operationalizing a common framework in order to grow trust by addressing issues such as privacy, security, business policy and practice challenges to move forward the ability to have secure and authenticated health information exchange through the care continuum.

The plan envisages working with all stakeholders and hone the use of healthcare IT infrastructure that was enabled through the HITECH Act in order to support the paradigm shift in healthcare towards a more patient centric, “less wasteful and higher quality system”.

In closing, they realize that it will take some time to be able to build an interoperable system that will improve the quality of care across the continuum, but say that HHS is committed to the cause of interoperability across all care settings through a roadmap that makes incremental changes that calls upon a collaborative focus to achieve the opportunities presented to all of us to improve the health and well being of our communities.

 

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