HITPC: Interoperability roadmap is ‘living document’
The Office of the National Coordinator for Health IT (ONC) will lead an effort to draft a “living document” to accompany its 10-year interoperability vision, Erica Galvez, ONC’s interoperability portfolio manager, told the Health IT Policy Committee at its meeting on Aug. 6.
Interoperability “is not going to happen overnight,” she said. “A roadmap provides a path forward that everyone can rally behind and perhaps more importantly, collectively update over time.”
A new, online interactive community is cornerstone to this endeavor, providing a “deep dive” into how all stakeholders can achieve three-, six- and 10-year interoperability milestones, she said. Under these timelines:
- By 2017, providers and individuals can send, receive, find and use a basic set of essential health information;
- By 2020, an expansion of sources and users of information while continuing to improve quality and lower costs. Also an increase in automation and ability to scale broadly;
- By 2024, stakeholders will practice precision medicine; reduce time from evidence to practice; and create a virtuous learning cycle or learning health system.
The paper will explore both policy and technical issues for advancing interoperability that go beyond Meaningful Use. “There will be tension between making rapid progress and being realistic about a timeframe,” she said.
Specifically, the companion paper is anticipated to address issues like:
- What are the critical technologies and policies (including governance) required to achieve the vision?
- Who needs to do what and by when? (including government, technology developers and technology users)
- How will the roadmap be updated over time and at what frequency?
The roadmap will revolve around nine operating principles: building upon existing health IT infrastructure; one size does not fit all; leverage the market; consider the current environment and support multiple levels of advancement; simplify; focus on value; empower individuals; maintain modularity; and protect privacy and security in all aspects of interoperability.
All parties interested in weighing in must do so by Sept. 12. The suggestions and feedback will be presented to the Federal Advisory Committees for their input and recommendations in October, with an updated version expected to be posted for public comment in March 2015, she said.
In comments following the presentation, Marc Probst, Intermountain Healthcare CIO, questioned whether the guiding principles “are trying to do too much.”
“Things like empowering individuals and focusing on value—that’s what we would do with interoperability if we already had it,” he said. He also asked who ultimately will oversee the realization of the vision.
Galvez said it remains to be defined who will oversee the vision, but that the document is voluntary and will be advanced through policy levers. “Enforcement we’ll need to think about.”
Charles Kennedy, MD, MBA, CEO of accountable care solutions at Aetna, commented that interoperability should focus more on particular problems that require solving, like chronic disease management, instead of just the exchange of data.
“We are not pursuing interoperability just for the sake of interoperability, but really to achieve larger goals for improved population health,” responded Galvez.
In other remarks, Galvez said health information exchanges are not considered “the only path forward” and that valuable technical and policy mechanisms exist to advance interoperability. “There is more to come.”