There are many issues that apply to the overlap between interoperability and health information exchange (HIE). So much so, in fact, that those organizing HIMSS16, the annual conference of the Chicago-based Healthcare Information & Management Systems Society (HIMSS), have combined the two subject areas into one, for purposes of the preconference symposium in that combined area, to be offered to attendees on Monday, Feb. 29, at the Sands Convention Center in Las Vegas.
Gary Ozanich, Ph.D., a visiting professor in the College of Informatics at Northern Kentucky University in Highland Heights, Ky. (in the greater Cincinnati metro area), is current national co-chair of the HIMSS Interoperability and Health Information Exchange Roundtable.
In that capacity, he helped to facilitate the discussions that led to the final program of the interoperability and HIE symposium. Among the sessions to be presented include “On the Road to Interoperability: Accelerating Through the Curves”; “Standards: Moving Beyond Meaningful Use”; Interoperability and Data Analytics”; “Facilitating Innovative Data Exchange and Re-Usability”; and “Striving for Semantic Interoperability.”
Gary Ozanich, Ph.D.
Recently, Ozanich spoke with HCI Editor-in-Chief Mark Hagland about the symposium and more broadly, about some of the broader issues facing healthcare leaders in the key areas of health information exchange (HIE) and interoperability. Below are excerpts from that interview.
Tell me about the development of the symposium’s program.
I think it’s very important to stress this: this program was put together by a committee of nine people. And it’s the committee who did this. This is the first year that HIMSS has basically merged the health information exchange and interoperability committees; they used to be two different committees, but now they’re one. So, nine people put the program together. It’s the fourth year I’ve worked on developing this particular symposium. I was basically responsible for writing the content. I’m a past chair of the HIE committee.
So the opening keynote session, “The Interoperability Roadmap in Practice,” will, according to its description, provide an update on progress made on the Shared Nationwide Interoperability Roadmap. Can you provide any hints about what might be shared with the audience?
Yes, as you noticed, Steve Posnack, director of the Office of Standards and Technology in the Office of the National Coordinator for Health IT, will present. Last year, we had Erica Galvez, and this year, it will be Steve. Basically, the session will provide an update, and based on last year, the model we used will be an extensive question and answer session with questions from the audience. And we’re expecting a large audience of about 350 people. What’s more, our audience tends to be very senior people very savvy people. So it will be a real opportunity to get an update from a senior ONC official.
Tell me a bit about the panel discussion-based sessions.
The rationale in the morning is that we sort of broke off in two directions. Track 1 is probably closer to the historical questions around interoperability and technology, and Track 2 is the content more traditionally around HIE, but of course, they’re very interrelated. And in Track 1, Elliot Sloane [Elliot Sloane, Ph.D., president, Integrating the Healthcare Enterprise (IHE)] will provide an update on the IHE initiative [Session 1 Track 1: Standards: Moving Beyond Meaningful Use]. And Terry O’Malley, whom you may know from Harvard [Terry O’Malley, M.D., a physician practicing in the Partners HealthCare System], and who’s done a really good job of bringing forward some new solutions that are standards-based—he has a lot of experience at Partners in terms of the practicality and problems around interoperability for a practicing physician. And Elliott will be talking about the progress being made towards implementing a healthcare data enterprise, and Dr. O’Malley will talk about the challenges of doing this is a practice session.
And the second session in Track 1 [Session 2 Track 1: “Interoperability and Data Analytics”] will involve Daniella Meeker [Daniella Meeker, Ph.D., assistant professor, Keck School of Medicine, University of Southern California] and Matt Hoffman [Matt Hoffman, M.D., CMIO, Utah Health Information Network]. And they’re doing really interesting things in Utah, doing health information exchange, and doing analytics based on that, for population health.
So, looking more broadly at the U.S. healthcare industry right now, do you see as the biggest HIE and interoperability issues around population health work?
And that leads to the afternoon sessions. Even when you achieve technical interoperability, semantic interoperability remains a huge issue. And with regard to Session 4—“Striving for Semantic Interoperability”—John D’Amore [John D’Amore, chief technical officer and president, Diameter Health] published a study in JAMIA [the Journal of the American Medical Informatics Association] focusing on semantic interoperability.
What do you see as the core semantic inoperability issues facing the industry right now?
My opinion is, it’s moving away from document exchange, and more discrete data element exchange that can be supported by FHIR. And we’re presenting a study Thursday at HIMSS, my co-researchers, Kelly Deavers, from Urban Institute, and I, are presenting it. And what do people need? The meds list and discharge notes. So if you’re looking at FHIR [the Fast Healthcare Interoperability Resources standard] or API [application program interface] solutions, you need to going and grab what you need and use well-understood web-based technologies—and that seems to me like a really good solution. The problem with the documents associated with the CCDA [consolidated clinical document architecture]—the CCD tends to be a pretty huge document, and we all know about the issue of workflow and meaningful use, right? And in that Session 3 [“Facilitating Innovative Data Exchange and Re-Usability”], Micky Tripathi [Micky Tripathi, Ph.D., president and CEO, Massachusetts eHealth collaborative] is presenting along with Richard Elmore [senior vice president, corporate development and strategy, Allscripts/CommonWell], and Rich works with CommonWell. And in the audience, we’ll have three other leading individuals who will be available for Q&A. So I know we’re going to have very good representation in this session from individuals who are currently developing FHIR standards and other solutions. Mickey referred to those folks as the founding fathers of interoperability. But the point is, we’ll have key individuals involved in the foundational work for FHIR, at this session.
How close are we to that—sending discrete pieces of data, using semantic interoperability?
In fact, over time, patients will be able to aggregate pieces of data, too. And one of the reasons this session is going to be so exciting---the people I talk to about this are saying 2018 or 2019, basically, when that will be common.
What do you hope people will take away from this day?
Well, first, we should mention the closing keynote—Jess Kahn [Jessica Kahn, director, data and systems group, Centers for Medicare & Medicaid Services] will speak about the whole issue of how policy is shaping the value-based purchasing and the role of interoperability in exchange, and how that can be driven by policy. I think when the committee put this together. ONC and CMS are sort of bookends as far as the keynotes are concerned. And we should really have the opportunity to deal with problems in the afternoon. One issue is this very exciting possibility of API-based solutions, and FHIR in particular. So I think it’s really going to be an exciting opportunity. And it’s great for HIMSS to be able to allow the volunteers free rein. And I think the committee did really good work in focusing on solving problems, and bringing very top-level people to the symposium, and I think it’s going to be a really exciting day.