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ONC Releases Final 2016 Interoperability Standards Advisory

December 23, 2015
by Heather Landi
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The Office of the National Coordinator for Health Information Technology (ONC) this week published its final version of the 2016 Interoperability Standards Advisory (ISA) identifying and assessing the best available standards and implementation specifications for supporting clinical health IT interoperability.

The 80-page ISA catalogs existing and emerging standards and specifications for specific interoperability needs and addresses health information exchange related to areas such as lab tests, medications, imaging, electronic prescribing, public health reporting and clinical decision support. And, according to ONC, when compared to the 2015 Advisory, the 2016 ISA has been “significantly updated and expanded in the span of less than one year.” The ISA is intended to be a “single resource for those looking for federally recognized, national interoperability standards and guidance.”

In an accompanying blog post, Steve Posnack, director for ONC’s Office of Standards and Technology, and Chris Muir, director for ONC’s HIT Infrastructure and Innovation Division, state that the 2016 Interoperability Standards Advisory includes “significant structural changes” and these changes expand the Standards Advisory’s depth and breadth. 

“Most notably, the 2016 Advisory includes six informative characteristics for each standard and implementation specification referenced. We believe that these characteristics will help provide stakeholders with more context regarding the relative maturity and adoptability of standards and implementation specifications,” Posnack and Muir state.

And, those characteristics help to set a baseline that will enable ONC to track industry interoperability progress over time as standards and implementation specifications get “updated and retired; move from draft to final; mature from pilot to production; and grow from low to high adoption,” Posnack and Muir wrote.

ONC released the draft ISA back in November, which attracted comments from industry groups and stakeholders. The Healthcare Information and Management Systems Society (HIMSS), in a letter to ONC officials, cautioned ONC about labeling interoperability standards in a simplified manner.

“Standards maturity is not a two-dimensional concept. There could be risks in trying to reduce it to such that could overly simplify a complex or nuanced topic. HIMSS recommends ONC consider the following three questions to better articulate standards maturity in future versions of the Interoperability Standards Advisory,”  H. Stephen Lieber, president and CEO of HIMSS, and Dana Alexander, chair of the HIMSS North America Board of Directors, wrote in a letter to ONC officials.

And, the American Hospital Association urged ONC to provide greater detail about the characteristics and metrics used to assess the standards identified as the “best available” including information on the readiness for use by providers to successfully meet government requirements.

ONC officials said the Interoperability Standards Advisory is part of the vision laid out in the Interoperability Roadmap to “drive more user friendly technology and connect the current infrastructure.”

“The ISA is a continuous, annual process where we make updates and improvements in order to keep pace with developments in the health IT industry—and the draft 2017 Advisory will be published in only nine 'short' months,” Posnack and Muir wrote.

The 2016 ISA includes a “projected additions” section representing additional interoperability needs, and ONC is seeking stakeholder feedback on those projected additions. That section includes standards for gender identity, sex and sexual orientation.

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