Intertwined between the lines

Mary Stevens, editor, CMIO magazine

Attestation for meaningful use incentives began this week and rightfully grabbed the spotlight as the next big test of the program for both providers and federal agencies. Interoperability will play an increasingly important role in Stage 2 and Stage 3 requirements for meaningful use, but there were other major developments that will drive connectivity efforts for years to come. ACO guidelines were also announced in the past month, as was the ONC’s proposed plan for federal health IT through 2015.

The term “interoperability” is seldom mentioned in these proposals, but it’s intertwined with the long-term prospects for each of these federal initiatives. In the ONC’s Federal Health IT Strategic Plan for 2011-2015, interoperability is, for all intents and purposes, the first goal of the five mentioned.

The ACO guidelines emphasize quality measure reporting capabilities and information exchange among a team of providers (read: a variety of data made sharable across systems). In addition, the newly chartered Center for Medicare and Medicaid Innovation will pilot innovative models for a nationwide technical support platform for ACOs, to complement the numerous ongoing efforts in which the private sector is already engaged, wrote CMS Administrator Donald M. Berwick, MD, MPP, in the New England Journal of Medicine following the ACO announcement.

The standards that will make that high-level integration a reality are continuing to evolve. A variety of IT vendors, organizations and integrated delivery systems plan to support the ONC’s Direct Project and 20 states have ONC-approved HIE plans that incorporate Direct, as outlined in a recent Webinar. The Direct framework, which specifies a basic way to securely exchange information, has some early examples of HIE. Among them is Rhode Island Primary Care Physicians, a practice of 160 primary care physicians, which was the first in the nation to exchange a complete, secure, encrypted message using the Direct Project framework, as Jeff Byers reported in the latest HIE Chronicles installment.

Another patient data exchange initiative announced during the past month was the Care Connectivity Consortium, under development by EMR service organizations including Mayo Clinic, Geisinger Health System, Kaiser Permanente, Intermountain Healthcare and Group Health. The group is working on its own electronic patient information exchange to protect patient confidentiality and use standards-based health IT to share data, according to consortium members. Participating health systems will be able to access and share information about the patient’s medications, allergies and health conditions, and the group aims to exchange data within the year.

It remains to be seen if these efforts converge at some point, or continue separately but agree to communicate—and how that affects system intragration and information exchange among entities.

Can your clinical systems exchange data with each other now? Let me know at mstevens@trimedmedia.com.