The Office of the National Coordinator for Health IT’s draft Nationwide Interoperability Roadmap has as its ultimate goal a learning health system in which every patient interaction generates data that can create new knowledge that results in improved clinical practices and outcomes.
By 2024, ONC envisions “an array of interoperable health IT products and services that support continuous learning and improved health.” However, Micky Tripathi, president and CEO of the Massachusetts eHealth Collaborative, says that end-state goal is “paralyzing more than enabling” because it doesn’t really inform providers and HIT vendors what they need to do now specifically to achieve interoperability.
Tripathi argues that what is lacking is a “public/private-based clear definition” of what constitutes nationwide interoperability. “We need to get to a definition that’s much more concrete and that’s about things that are mostly focused on what can be done within networks and across networks,” he states. “It’s an important first step to achieving interoperability and we don’t have that right now.”
Not surprisingly, in poll results released last month, only 17 percent of provider respondents said they are confident that the healthcare industry will meet the 10-year goal for nationwide interoperability set by ONC—namely, to create a learning health system.
“Rather than going to the extreme of saying the goal is a learning health system, I’d go the opposite direction and say nationwide interoperability constitutes—for example—these five focused and precise things in a bottom-up rather than a top-down approach,” advises Tripathi.
Just as electricity grids formed in the energy sector and ATM systems interoperate today in the banking industry, health IT networks must “define the common things that we want them to do” and then identify the “bridging technologies” between them to link these data silos and assure that patient identity matching can happen across the networks, he says.
Yet, Tripathi asserts that “everything locally does not necessarily have to happen nationally.” For instance, he references the fact that health information exchange network CommonWell Health Alliance has a record locator service while eHealth Exchange does not.
“I think that we’ve operated in many ways under an assumption that every network needs to be the same and that’s how we have interoperability,” he observes. But, according to Tripathi, it’s “okay” that these networks “do their own thing as long as patient matching happens across those networks.”
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