A wide range of healthcare industry stakeholders met last week, laying down strategy to coordinate efforts and fill gaps to achieve interoperability.

Health Level Seven organized the meeting in Chicago, held at the American Medical Association and drawing about 30 representatives from nearly every vertical in the industry, and particularly gaining engagement from several professional associations and medical societies.

The meeting is one of the latest in recent weeks, as diverse stakeholders are coming together to work on interoperability. For example, executives of 12 major electronic health record vendors met earlier this month and agreed to a set of metrics for measuring progress toward interoperability.

See Also: EHR Vendors Agree to Uniform Interoperability Metrics

The meeting “exceeded my wildest expectations” for industry participation, said Charles Jaffe, M.D., HL7’s CEO. He added that the participants want to continue to work together and a follow-up meeting may be planned for February.

The Chicago meeting gave HL7 some key recommendations to advance interoperability, Jaffe said. One was support and direction for enhancements to HL7’s Clinical Document Architecture (CDA), a standard for document markup that specifies the structure and semantics of clinical documents, such as Continuity of Care Documents.

HL7 has a five-year grant to support continued enhancement of CDA, the creation of CDA tooling and refinement of some of the CDA functionality, and the organization is looking for continued funding to support work in this area, Jaffe said.

Meeting participants also offered further collaboration for supporting work needed to achieve Meaningful Use, particularly development of open application programming interfaces (APIs) that will be needed to exchange information between clinical systems, a requirement under Stage 3 of the Meaningful Use incentive program.

Participants also supported continued efforts by the Argonaut Project, a multi-stakeholder group comprising vendors and leading provider systems to develop a first-generation API and Core Data Services specification to enable expanded information sharing for electronic health records, documents and other health information.

The Argonaut Project looks to enhance the development of FHIR, a standard being developed by HL7 to facilitate the exchange of health information between healthcare organizations. The Argonaut Project is entering a second phase that will create testbeds for sharing, “sandboxes” to support developments of APIs and help desk services, and other support to ensure compliance with FHIR standards, Jaffe said.

The Chicago group also encouraged use of cloud-based testing to enable HL7 to “get more agile and improve conformance testing,” Jaffe said. “There was great support behind the notion of having asynchronous cloud-based testing so that we don’t have to rely on face-to-face connectathons, which are events that provide cross-vendor supervised and structured testing.

Cloud-based testing will offer wider opportunities for testing, for example, to see what happens when messages that don’t conform to standards are sent, Jaffe said. “Without doing that, you really haven’t stressed the system adequately. It also would enable iterative testing, so that every time you add to a system or refine a draft, you can test it in a very cost-effective way. Healthcare IT is ever changing, and the ability to manage conformance testing is really critical.”

Jaffe said he was impressed by the support for interoperability and the cooperation between those who were at the Chicago meeting.  “It was quite remarkable just how well aligned the community was,” he said. “There was virtually no contentious discussion; people were remarkably on board despite the fact that they came from different communities and had dramatically different business needs.”

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