'Hugely ambitious' plans for interoperability roadmap revealed

Advancing interoperability is a complex topic that will require prioritization, said Erica Galvez, manager of the Office of the National Coordinator of Health IT’s interoperability and exchange portfolio. She presented during a joint meeting of the Health IT Policy and Standards Committees on Oct. 15.

“This is about people,” she said, “and technology supporting the decisions people made with regard to their health. We really have to think about technology and interoperability of information at points of decision making beyond the doctor’s office, the emergency room and the public health department.”

Galvez outlined a plan that incrementally builds interoperability over time. “There is lots of room for improvement but we’re not starting from zero. We’re focusing nationally on establishing a best minimum possible—a floor of interoperability across which all key players can participate and innovation can flourish.”

Building the interoperability roadmap will require unprecedented collaboration, she said, and the process must describe who should do what by when to make sure interoperability expectations are met.

The efforts to date established five building blocks:

• Core technical standard and functions
• Certification to support adoption and optimization of health IT products and services
• Privacy and security protections for health information
• Supportive business, clinical, cultural and regulatory environments
• Rules of engagement and governance

Galvez often referred back to the ONC’s June vision paper on interoperability which also identified guiding principles including empowering individuals, simplify wherever possible, support multiple levels of advancement and protect privacy and security in all aspects. Galvez went over feedback on the building blocks. Stakeholders said, for example, that new national standards should not be adopted until they are fully tested and matured. Regarding privacy and security, they expressed a strong desire for consistency and clarity in policies and standards for exchanging data.

After her presentation, several committee members had suggestions for the next iteration of the roadmap plan. They included expanding beyond consent as a mechanism for authorization to access data; include information about provenance of data; more thought on the usability of exchanging data; and more consideration of scale and scope.

“Data is pushing at the doors, ready to come out,” said Karen DeSalvo, MD, MPH, MSc, ONC head. “Consumers are picking the lock. They are ready to have that information available. Our job is to make sure we have the policy and technology framework.” She and other committee members repeatedly acknowledged the massive and complex undertaking that is the process of creating an interoperability roadmap.