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ONC Releases Proposed Interoperability Standards Measurement Framework

April 28, 2017
by Heather Landi
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The Office of the National Coordinator for Health IT (ONC) is soliciting feedback about a proposed industry-wide measurement framework, which it released this week, to assess the implementation and use of healthcare interoperability standards.

In the measurement framework document, ONC states, “Moving towards a set of uniform and trackable nationwide interoperability measures is essential to demonstrate progress towards achieving the Roadmap’s [Shared Nationwide Interoperability Roadmap] goals Measuring interoperability is also essential to monitoring progress towards a goal set by Congress. In the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Congress declared a national objective to achieve widespread exchange of health information through interoperable certified electronic health record (EHR) technology nationwide by December 31, 2018.”

The purpose of the Proposed Interoperability Standards Measurement Framework, ONC states, is to determine the nation’s progress in implementing interoperability standards in health information technology (health IT) and the use of the standards as a way to measure progress towards nationwide interoperability.

Currently, stakeholders’ capabilities to measure interoperability standards vary significantly across the health IT ecosystem, ONC stated, and this variability presents significant challenges to tracking national interoperability progress on the implementation and use of standards.

ONC is seeking public comments on its proposed interoperability standards measurement framework and how to best engage data holders and other relevant stakeholders in implementing the proposed framework.

ONC is accepting public comment on the proposed interoperability standard measurement framework until Monday, July 31, 2017.

In an ONC Health IT Buzz blog post, Steven Posnack, director, office of standards and technology at ONC, notes that experience has shown that just because technology includes “standardized” capabilities they are not necessarily used to their fullest extent nor are they always implemented in a “standardized” manner. “From a health information technology (health IT) perspective, this is especially true when other non-standard/non-computable options exist (e.g., fax), business incentives are misaligned, and in cases where exchange partners cannot equally benefit from standardized data exchange (among other reasons),” he wrote.

Further, Posnack wrote, “When it comes to evaluating interoperability from a technical perspective, one “simple” question to ask is: did the people who developed the health IT in use implement the same standards in the same way to solve the same problem? The Interoperability Standards Advisory (ISA) seeks to give some guidance on standards measurement by estimating a standard’s implementation and use in the field. However, for many standards today publicly reported, quantifiable data regarding their implementation and use is often not readily available or regularly tracked.”

Further Posnack noted that “measuring for what purposes and to what extent interoperability standards are being implemented and used is of particular importance because it can identify industry trends as well as areas where standardization on its own appears not to be enough to prompt widespread use.”

ONC released, for public comment, the proposed measurement framework to gain consensus on industry-wide measures to assess the implementation and use of standards. “ONC recognizes the critical role that health IT developers, health information exchange organizations, and health care organizations will need to play to develop an agreed upon set of measures to assess the implementation and use of standards,” Posnack wrote.

ONC wants feedback to help engage and coordinate with stakeholders, Posnack said. “Ultimately, a finalized measurement framework would enable aggregate, industry-wide statistics that could be used as a resource by all stakeholders to inform business decisions, enrich policy deliberations, and enhance the accuracy of the guidance provided by the ISA,” he wrote.



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