In May, a group of federal officials from several agencies released a draft framework describing an idealized future for health information technology, and highlighting where research and development gaps may exist.

Doug Fridsma, MD
Doug Fridsma, MD

The framework came from the Networking and Information Technology Research and Development Program (NITRD), which is an agency under the White House. It included a comment period to solicit input from the healthcare industry.

The importance of this framework cannot be overstated, says Doug Fridsma, president and CEO at the American Medical Informatics Association. “This document is an important signal that the government understands it has a role to play in the ongoing evolution of health IT.”

Jeff Smith, vice president of public policy at AMIA, gives an example of why ongoing evolution of HIT needs federal support. “Just because we have car batteries and have been using them for years does not mean that the Department of Energy should stop research on how to make batteries better.”

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Consequently, AMIA submitted comments generally in support of the NITRD framework and emphasizing the need for officials to work with the health informatics community as well as the general health IT industry.

Of particular importance, AMIA noted, is the need for increased federal support for new and novel types of clinical decision support that move away from smaller demonstrations to large-scale projects.

One of the most important needs is the move to “true interoperability testing,” Smith says. For example, the current certification process of health IT products under the electronic health record meaningful use program tests for conformance to established standards, and that has not resulted in an interoperable environment.

What the industry now needs is a higher bar to confirm that a certified information system is truly interoperable. That means the system not only can send a Continuity of Care Document using established standards, but also can receive that type of standardized format as well. Right now, Smith asserts, certification only focuses on the sending of a document.

AMIA suggested the following recommendations in its comment letter.

• Using data to improve the safety, reliability and quality of healthcare is paramount. “Funding efforts meant to make sense of the oncoming deluge of data in the service of care delivery and wellness represents one of the largest opportunities faced by the federal government.”

• Federal agencies must support basic, applied and advanced informatics training. “AMIA strong encourages federal agencies to understand their duty to support a modern 21st Century healthcare workforce.”

• Policy development, in addition to technology development, is needed for a host of information systems. “Data generated by systems including laboratory, imaging, consumer mHealth and medical devices have the potential to transform health. These systems are either governed by different programs/policies or are not regulated at all, in the case of mHealth.”

The “Draft Federal Health Information Technology Research and Development Strategic Framework” is available here.