Fridsma hosts a hangout

Doug Fridsma, chief scientist, hosted the Office of the National Coordinator of Health IT’s first Google+ Hangout on Feb. 11. He discussed the office’s main activities and plans for continuing to transform healthcare with IT.

The ONC performs the following activities, Fridsma said:

1. Enable stakeholders to come up with simple shared solutions. “This really represents the work we’re doing on the interoperability framework and how we’re supporting implementation and testing of some of our technology.”

2. Curate portfolio of standards, services and policies that accelerate information exchange.

3. Support innovation through the SHARP program, innovation and challenge grants, and interface with the international standards community. “We need to make sure that the standards we create and policies we adopt will actually drive innovation or, at least, not inhibit innovation.”

4. Collaborate with federal agencies to coordinate federal health IT priorities as the manager of the Federal Health Architecture (FHA).

These efforts can’t happen in a big bang fashion, he said, but incrementally, so “we can learn from each step. Our job is to enable others to achieve success and take an approach that allows for heterogeneity. It’s challenging because different organizations are in different stages of maturity in being able to exchange information.”

The office is mindful of the best way to move forward with various initiatives, Fridsma said. “When we’re thinking about moving forward with a particular initiative, it may not be perfect but does it represent the best we have so far? We cannot let perfect be the enemy of good.” Interoperability is not a one-size-fits-all concept. “We want to create modular standards and specifications that allow for innovation.”

The ONC also wants to leverage the community to bring together the best people and ideas. “We are on a journey together. There are lots of smart people out there that we can help, support and coordinate their efforts.”

Fridsma said he is considering more transparency going forward. If various organizations, agencies and workgroups put upcoming upgrades and similar efforts on a public list or change log, vendors would be able to anticipate where they can insert themselves in the process. With better transparency, “regulations become just a roll-up of the conversations that happened 6 to 18 months before. People can anticipate what might be changing. That creates a pathway so that we all can work together, and not be so reliant on Meaningful Use regulations but leverage other things going on with accountable care and other initiatives.”

Fridsma discussed the need for more conversations with the public about what is missing from the current portfolio the ONC offers. “Do we need different kinds of standards and services that will allow for shared care plans, for example? That’s a conversation we need to have.”

He also explained that the activities of the Federal Health Architecture (FHA) started right around the time ONC was established. When initially conceived, the FHA was thought of as an enterprise architecture activity. It’s now an interoperability architecture, Fridsma said, “so we don’t necessarily have to change what a particular agency does inside but focus on ways they might exchange between agencies.” Having several federal agencies focus together “has been an important aspect in keeping us connected to important agencies that are struggling to exchange information.”

New workgroups specifically focused on consumers and consumer engagement are geared to engaging consumers “not only from policy but from technology,” Fridsma said. What technologies are helpful to them and how can we develop standards to engage the consumer side of things? Fridsma indicated  more workgroups will soon be announced. “I don’t want two separate but equal systems where one is geared to providers and EHRs and one is geared to consumers and mobile devices and home monitoring. The system needs both to come together and share information. We have not succeeded if the patient is seen as a separate participant from the rest of the system. We need a unified approach.”