The Office of the National Coordinator for Health IT on Friday released for public comment a draft Interoperability Roadmap aimed at promoting, facilitating, and enhancing the safe/secure exchange and use of health information nationwide.

The 166-page draft document proposes “critical actions for both public and private stakeholders that will advance our nation towards an interoperable health IT ecosystem, advance research and ultimately achieve a learning health,” according to ONC. Erica Galvez, ONC’s interoperability portfolio manager, told reporters in a press briefing that the draft roadmap is “built around” the concept of nationwide interoperability.

“There have been a number of successful efforts focused on exchanging health information and in some cases even achieving interoperability in regional settings, integrated delivery networks, and a number of sub-national venues,” said Galvez. “But, the reality is none of those efforts to date have scaled to the level we need them to scale in order for information to follow a person wherever they need it, regardless of geographic and organizational boundaries.”

In the near term, Galvez said that over the next three years the roadmap’s goal is “focused very specifically on making sure that the majority of care providers across the broad care continuum and consumers reach a place where they can electronically send, receive, find and use a specific set of critical health information.”   

The roadmap is organized around five building blocks for a nationwide interoperable health IT infrastructure: core technical standards and functions; certification to optimize health IT products and services; privacy and security; business, clinical, cultural and regulatory environments; and rules of engagement and governance. On the governance front, Galvez said “the reality is that there is not a clear process or set of rules for facilitating interoperability across existing networks and regions.” As a result, she said ONC is committed to establishing a “nationwide framework with a common set of rules of the road” and “a mechanism for recognizing the organizations that comply with those rules and holding organizations accountable to do so.”     

In addition to the roadmap, ONC released a companion draft 2015 Interoperability Standards Advisory representing its assessment of the “best available standards and implementation specifications for clinical health information interoperability” as of December 2014. The draft advisory is “meant to provide the industry with a single, public list of the standards and implementation specifications that can best be used to achieve a specific clinical health information interoperability purpose.”

The advisory, which identifies specific standards and references implementation guidelines across four areas of standards—content, vocabulary, transport and services—is a non-binding, non-regulatory document meant to help facilitate discussion and debate on clinical standards currently used in healthcare and referenced in regulation. While the 2015 Advisory focuses on clinical health IT interoperability, ONC says the scope of future advisories “may be expanded as necessary and appropriate to support the Interoperability Roadmap’s evolution as well as other national priorities.” Steven Posnack, director of ONC’s Office of Standards and Technology, said the advisory will be updated annually.

“We look forward to doing this in partnership with the private sector,” said National Coordinator for Health IT Karen DeSalvo, M.D., who emphasized that the draft roadmap was developed with input from industry and is “designed to be something that we use together—a shared opportunity to really make a difference in the country…What we have clearly heard from partners in the public and private sector is that the time has come for us to be more explicit about standards.”

The College of Healthcare Information Management Executives welcomed the release of ONC’s 2015 Standards Advisory as part of the broader Interoperability Roadmap. “This is a much-needed playbook for each and every health IT professional,” said CHIME President and CEO Russell Branzell. “Now, healthcare providers and health IT developers have a single source of truth, with an extensible process to align clinical standards towards improved interoperability, efficiency and patient safety. While we have made great strides as a nation to improve EHR adoption, we must pivot towards true interoperability based on clear, defined and enforceable standards.”

Currently, ONC is accepting public comments on the Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Draft Version 1.0. The comment period ends at 5 p.m. ET on April 3. ONC is also accepting public comments on the 2015 Interoperability Standards Advisory, which will end at 5pm ET on May 1.

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