The Office of the National Coordinator for Health Information Technology on Thursday released a paper outlining its 10-year vision for achieving a nationwide interoperable health IT infrastructure.

"This paper is an invitation to health IT stakeholders--clinicians, hospitals, public health, technology developers, payers, researchers, policymakers, individuals, and many others--to join ONC in figuring out how we can collectively achieve interoperability across the health IT ecosystem," states the 13-page document. ONC defines an interoperable health IT ecosystem as one that "makes the right data available to the right people at the right time across products and organizations in a way that can be relied upon and meaningfully used by recipients." 

By 2024, ONC envisions an array of interoperable health IT products and services that "allow the healthcare system to continuously learn and advance the goal of improved healthcare." This “learning health system” should "enable lower healthcare costs, improved population health, truly empower consumers, and drive innovation," argues the paper.

Writing in a blog, National Coordinator for Health IT Karen DeSalvo, M.D., states that achieving ONC's 10-year vision will take a strategic and focused effort by the federal government in collaboration with state, tribal, and local governments and the private sector. Toward that end, DeSalvo calls for developing a shared agenda that focuses on five critical building blocks for a nationwide interoperable health IT infrastructure: core technical standards and functions; certification to support adoption and optimization of health IT products and services; privacy and security protections for health information; supportive business, clinical, and regulatory environments; and rules of engagement and governance.

"These building blocks are interdependent and progress must be incremental across all of them over the next decade to realize this vision," asserts DeSalvo. "We will collaboratively develop use cases and goals for three, six and ten-year timeframes that will guide work in each of the building blocks, including alignment and coordination of prioritized federal, state, tribal, local, and private sector actions."

In response, Joel White, executive director of Health IT Now, calls ONC’s vision to achieve greater interoperability "long overdue" and makes the case that in order to be successful ONC "must now produce a specific work plan with timelines that achieves the greatest degree of integration." However, White says that 10 years is too long to wait. Health IT Now recommends that ONC advance the timeframe for achieving interoperability dramatically and that this level of information sharing and use should be achieved within three years.

"We are now going into the fourth year of the Meaningful Use program, which has focused on automation of provider practices and transaction processing using technology best suited to fee-for-service models," says White. "Automating yesterday’s health system wasn’t and isn’t the answer. We need to achieve ONC’s vision more rapidly to give patients the technology they need to actively engage in their own health and wellness." 

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