The American Hospital Association is urging the Office of the National Coordinator for Health IT to provide more specific information on the characteristics and metrics it has used to assess the readiness of standards and implementation specifications in its draft 2017 Interoperability Standards Advisory.
According to ONC, the advisory is meant to serve as a “coordinated catalog of standards and implementation specifications” to be used by industry as a single, public list to meet interoperability needs focused explicitly on clinical health IT. However, AHA would like to see greater detail in how ONC distinguishes mature from emerging standards.
“The consistent use of mature standards is essential to solving the interoperability challenges facing our nation,” wrote Ashley Thompson, AHA’s senior vice president for public policy analysis and development, to National Coordinator for Health IT Vindell Washington, MD.
In particular, AHA wants to see ONC prioritize outreach to organizations conducting maturity assessments so that future versions of the Interoperability Standards Advisory (ISA) can include this reference. The association also recommends that the agency use the ISA to make publicly available the feedback it receives on the adoption experience of standards and implementation specifications.
Further, AHA advises that the 2017 ISA also include information on actual standards use in the real world, and not just adoption.
“The Draft 2017 ISA uses the term ‘adoption level’ to indicate whether a standard has been adopted in healthcare and a graphic to indicate the level of adoption, from low to high, for a particular standard,” writes Thompson. “However, experience to date indicates that a standard may have a high adoption rate as a result of a health information technology certification requirement, although it does not meet provider needs. The Direct standard is an example of this misalignment.”
As a result, AHA contends that the draft 2017 ISA must assess the successful use of the included standards, not just adoption, in order to properly evaluate the ability of a standard to support interoperability.
In addition, AHA recommends that ONC support the work of private-sector initiatives that are educating stakeholders about the availability and readiness of standards, especially as they pertain to interoperability.
“The majority of the standards included in the Draft 2017 ISA do not indicate whether a test tool is available to evaluate conformance to the standard or the implementation specification,” states the letter. “Positive results from conformance testing will add confidence that a standard is ready to support the interoperability needs of providers.”
An ONC spokesman said that the agency does not respond to written comments, such as those from AHA, although it does review them and they will help to inform the final advisory.
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