The Office of the National Coordinator for Health Information Technology is looking for industry guidance on how to achieve and measure interoperability of electronic health information.

In a request for information published Wednesday, ONC seeks industry comment on establishing metrics to determine if or to the extent to which electronic health records are interoperable. The public comment period extends until June 3.

The push to achieve interoperability is in response to last year’s mandate by Congress, contained in the Medicare Access and CHIP Reauthorization Act (MACRA). Among provisions of that law is a requirement to achieve “widespread” interoperability of health information by the end of 2018.

If HHS determines that the objective was not reached by the deadline, “the Secretary shall submit a report to Congress that identifies barriers to this objective and recommends actions that the federal government can take to achieve it,” ONC notes in the RFI.

The agency will focus on three core topics:

  • “Measurement population” (providers) and key components of interoperability that should be measured.
  • Current data sources and potential metrics to assess success in meeting MACRA requirements.
  • Other data sources and metrics that should be considered to support more broad measurements of interoperability.

Information supplied to ONC by stakeholders will inform the agency on how to assess interoperability among providers who are meaningful users under the Medicare and Medicaid EHR Incentive Programs, as well as clinicians and other providers with whom these meaningful users exchange clinical and other information. These “exchange partners” may or may not be meaningful users.

ONC also want to measure interoperability “by identifying measures that relate to both exchange of health information as well as use of information that has been exchanged using common standards,” according to the RFI. This will include examining such components as electronically sending data, receiving data, finding requests or querying, incorporating information received on a patient’s medical record, and subsequent use of information received electronically from outside sources.

Questions in the RFI cover whether the focus of measurements should be limited to meaningful EHR users, how clinicians participating in alternative payment models should be addressed, the degree to which various measures of interoperability will adequately address both data exchange and use, and whether the focus of measurements should be limited to only certified EHR technology or include non-certified systems as well.

The request for proposal is available here.

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