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ONC Releases Final Interoperability Roadmap

October 7, 2015
by Heather Landi
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The Office of the National Coordinator for Health Information Technology (ONC) released its final Interoperability Roadmap on Oct. 6 laying out the steps needed to achieve an interoperable health IT infrastructure in 10 years.

Interoperability is necessary to achieve a “learning health system” in which health information flows seamlessly to improve individual, community and population health, according to the ONC’s vision as outlined in the report, Connecting Health and Care for the Nation, A Shared Nationwide Interoperability Roadmap.

The final report is the result of months of health IT stakeholder feedback, including public comments from more than 250 organizations, received by ONC in response to a draft Interoperability Roadmap released in January.

In the report, ONC calls on public and private stakeholders to address policies and technical approaches to achieve seamless interoperability. The report indentifies three overall goals—to help consumers easily and securely access their electronic health information when and where they need it most; enable individual health information to be shared with other providers and refrain from information blocking and to implement federally recognized, national interoperability standards and policies.

In a letter in the Interoperability Roadmap, Karen DeSalvo, M.D., National Coordinator for Health Information Technology, credited the work by the private and public sector during the past decade and the investment under the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 for stimulating significant health information technology (HIT) adoption and exchange of electronic health information.

“We must build upon this success to create an open, person-centered health IT infrastructure,” DeSalvo wrote.

In the new report, ONC reiterated its commitment, as stated in the first Roadmap announced in January, to shifting and aligning federal, state and commercial payment policies from fee-for-service to value-based models to stimulate the demand for interoperability.

By the end of 2016, CMS aims to administer 30 percent of all Medicare payments to providers through alternative payment models that reward quality and value and encourage interoperability, according to the Roadmap. By 2018, CMS will seek to do so for 50 percent of all Medicare payments. And the report states that by 2024, CMS will use value-based payment models as the dominant mode for payment for providers.

The report outlines a timeline of actions, in three-, six-, and 10-year milestones, to guide stakeholder focus in the near- and long-term toward the goal of achieving an interoperable exchange of electronic health information.

By the end of 2017, the ONC intends for the majority of health providers and consumers to be able to send, receive, find and use a common set of clinical information in order to improve health care quality and outcomes.

In six years, by the end of 2020, ONC intends to expand data sources and users in the interoperable health IT ecosystem to improve health and lower costs.

The ultimate goal, to be achieved by 2024, is nationwide interoperability that enables a learning health system, “with the person at the center of a system that can continuously improve care, public health and science through real-time data access.”

With a focus on “patient-centered health care,” the ONC’s report also outlined milestones to enable individuals to be active in managing their health and partnering in healthcare, enabled by information and technology. By 2020, ONC aims to have consumers able to regularly access and contribute to their longitudinal electronic health information via health IT, sending and receiving information and using that information to manage their health. And, by 2024, according to the report, ONC envisions consumers will be able to seamlessly integrate and compile their longitudinal electronic health information across online tools, mobile platforms and devices to participate in shared decision-making with their care, support and service teams.

Representatives from the U.S. Department of Health and Human Services (HHS), the Department of  Defense (DoD), the National Institutes of Health (NIH) and the Department of Veteran Affairs (VA) among many other agencies offered statements of support for the final Interoperability Roadmap.

There also have been numerous endorsements for the Roadmap from various industry associations.

“ONC’s dedication to improving the status of interoperability is to be commended. CHIME and the nation’s CIOs look forward to continuing to work with ONC to foster a standards-driven, interoperable healthcare delivery system,” Charles Christian, chairman of the board of trustees for the College of Healthcare Information Management Executives (CHIME), said in a statement.

“We look forward to future and ongoing collaboration with ONC and others, including consumers, in seeking solutions that will work across the healthcare ecosystem, ultimately increasing quality and outcomes, removing access barriers and lowering costs. Nothing is more essential to providing safe, quality patient care than the ability to select the correct patient in each and every encounter, ensure that data is available in formats that are standardized for understanding and consumption and in secure, lawful circumstances,” Lynne Thomas Gordon, chief executive officer for the American Health Information Management Association, said.




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