Charting a course towards HIE governance

Health information governance (HIE) is one of five key components of the Office of the National Coordinator for Health IT’s (ONC's) 10-year interoperability vision, and the agency currently is immersed in establishing “rules of the road” to further exchange, said Jodi Daniel, director of ONC's office of policy planning, speaking during a Sept. 18 webinar corresponding with National Health IT Week.

The 10-year interoperability vision ultimately fulfills ONC’s statutory purpose under the HITECH Act: “to establish a governance mechanism for the nationwide health information network,” she said.

Daniel shared the recent history of ONC’s work to realize that mandate.

In 2012, the agency had solicited public input on conditions for trusted exchange within a nationwide health information network. “What we heard is that there are a lot of activities going on and a lot of promise. We also heard that it’s too soon and that we should watch and wait,” said Daniel. In September 2012, ONC announced its decision not to continue with the rulemaking process, and take the advice of commenters to watch things as they unfold, encourage good processes, share information and learning, and promote solutions to problems.

During the past two years, ONC has entered into two cooperative agreements with existing HIE governance entities—DirectTrust.org and New York eHealth Collaborative—to work on a framework and principles of exchange. This effort, which dovetailed work to prepare for Meaningful Stage 2, enabled the agency to develop a governance framework that hinges on four pillars: organizational, trust, business and technical.

“This was a key piece in driving some of the other work,” particularly the national HIE governance forum, which involved HIE governing entities identifying their common challenges and potential solutions, she said.

Moving forward, the 10-year interoperability vision sets out to achieve the following goals for HIE governance:

• By 2014, ONC will build on our existing governance framework and principles to ensure individual access, privacy, transparency, responsible financial and business practices and use of federal standards to support HIE;
• ONC will identify, as needed, “rules of the road” necessary for information to flow efficiently across network; and
• The U.S. will transition to a governance approach for HIE that involves collaboration from all stakeholders, including the government, healthcare organizations and consumer representatives.

A subgroup of the health IT policy committee’s interoperability workgroup currently is establishing HIE governance principles for a draft interoperability roadmap scheduled for release in January. The subgroup is expected to share their findings on HIE governance at the committee’s regularly scheduled meeting in October, she said.

When the January roadmap comes out, “Give us feedback and tell us what you think,” Daniel said. “We’ll be incorporating your input into our thinking and into our final roadmap.”