Electronic Health Records

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ONC targets 2024 for full health IT interoperability

By Kyle Murphy, PhD

The Office of the National Coordinator for Health Information Technology (ONC) has set its sights on 2024 as the target for achieving system-wide interoperability in the United States, according to ten-year plan published recently by the federal agency.

Writing on HealthITBuzz, National Coordinator Karen DeSalvo, MD, MPH, MSc, has drawn attention to the release of an ONC paper outlining her department’s timeline for creating a health IT infrastructure capable of supporting the secure and efficient flow of data among providers, patients, and researchers.

The current National Coordinator has championed the cause of interoperability since assuming her post in the beginning of 2014 and it appears it will be her legacy:

“We know that consumers increasingly demand that their data flow and follow them across care settings and beyond,” she wrote last week. “Payment and delivery system reform are driving a desire from employers, payers, and health systems to share data to reduce redundancy and waste and improve care. Clinicians are ready for data to enable and inform care and improve their efficiency. Innovators are stretching our imagination on ways to collect and appropriately use data to improve health. And evolving technology is providing us with promising new ways to achieve interoperability.”

So what is the ONC’s plan for achieving interoperability? It consists of three parts.

First is a three-year plan comprising efforts to develop an interoperability roadmap and “fine-tune” the health IT systems and services enabled by the Health Information Technology for Economic and Clinical Health (HITECH) Act. The sending, receiving, and searching of health information will be made scalable and extended along the continuum of care.

The second phase, the six-year agenda, looks to enhance interoperability by enabling all stakeholders in a patient’s care to contribute to the health record of that patient and integrating information from other sources (e.g., payers, medical devices clinical data registries) into the “interoperable technology ecosystem.” This next step should allow providers to identify and respond to health trends in patient populations more efficiently and effectively.

The third and concluding phase of the plan aims at having a health IT infrastructure in place sufficient to support all levels of public health ten years from now. Aggregated data from across the country will be able to provide well-informed clinical decision support at the point of care by bringing the macro to bear on the micro.

The ONC foresees its goal being realized through the use of five building blocks:

• Core technical standards and functions
• Certification to support adoption and optimization of health IT products and services
• Privacy and security protections for health information
• Supportive business, clinical, cultural, and regulatory environment
• Rules of engagement and governance of health information exchange

Although the plan appears to contain a clear direction, it also establishes a goal that is many years removed from the present. Up until this point, the message from the ONC and Centers for Medicare & Medicaid Services (CMS) pertaining to EHR Incentive Programs was that Stage 3 Meaningful Use, the last fully-incentivized phase of the program, would have the following characteristics beginning in 2016 (via HealthIT.gov):

• Better clinical outcomes
• Improved population health outcomes
• Increased transparency and efficiency
• Empowered individuals
• More robust research data on health systems

Either this timeline only applies to EHR adoption and not health IT more generally or the task at hand requires twice the time previously estimated to achieve true interoperability.

Read the full ONC roadmap here.

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