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October 8, 2015

ONC: Here's our roadmap to achieving nationwide interoperability in 10 years

Daily Briefing

    The Office of the National Coordinator for Health IT (ONC) on Tuesday released its final 10-year nationwide interoperability roadmap to advance the safe and secure exchange of electronic health data.

    Details of roadmap

    The document, titled "Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap," is based off of recommendations from stakeholders' public comments and industry experts.

    According to National Coordinator for Health IT Karen DeSalvo, the roadmap focused on ways to align incentives, develop an appropriate governance structure, and implement the necessary technical standards and specifications to achieve nationwide interoperability.

    Roadmap timeline

    The roadmap outlines a phased-in timeline for achieving interoperability over the next decade:

    • 2015 to 2017 will focus on sending, receiving, finding, and using priority data domains to improve the quality of care and health outcomes;
    • 2018 to 2020 will focus on expanding interoperable health IT and users of such technology to improve health and reduce costs; and
    • 2021 to 2024 will focus on achieving nationwide interoperability to enable a learning health system.

    Specifically, by 2017 CMS aims to administer 30% of all Medicare payments to providers through alternative payment models intended to bolster interoperability, and ONC aims to achieve a 2% or less internal duplicate record rate among organizations with matching electronic health records (EHRs), dropping to 0.5% by 2020 and 0.1% by 2024.

    How data sharing will change for providers in 2015

    According to the roadmap, by 2020:

    • More than 50% of health IT developers should offer access to electronic health data through standard, public application programming interfaces, increasing to more than 75% by 2024;
    • ONC aims to have set standards for health data domains;
    • Patients should be able to access and contribute to their EHR, as well as electronically send and receive data to manage their care; and
    • Providers should be able to self-test their health IT for interoperability.

    And by 2024, the roadmap says patients should be able to easily integrate electronic health data across online tools and mobile platforms, and providers should be able to test their systems for interoperability using a comprehensive testing structure.

    Interoperability is the key to innovation. So what's the delay?

    Other roadmap details

    The roadmap offered guidance to help create a standardized set of clinical data that should be used for every patient, noting that such priority data should include:

    • Basic information, such as patient name, sex, and date of birth;
    • Information on a patient's history, such as allergies, immunizations, medications, medical complications, smoking status, and vital signs;
    • Providers' notes and narratives; and
    • A physician care plan, including patient goals and instructions.

    In addition, the roadmap calls for quickly transitioning the health care industry from fee-for-service models of payment to value-based models of payment and seeks to align federal and state privacy and security standards.

    According to DeSalvo, ONC is working with the National Governors Association to address the variance in state privacy laws (Conn, Modern Healthcare, 10/6; Mearian, Computer World, 10/7; Green, Becker's Health IT & CIO Review, 10/6; Slabodkin, Health Data Management, 10/6).

    How to understand interoperability—our industry's most overlooked problem


    You've heard about health insurance. You've heard about medical errors. But have you heard about interoperability? It could be costing the health care industry as much as $30 billion per year.

    So what is it?


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