ONC sets interoperability goals

As its vision for the future, the ONC stated: "An interoperable health IT ecosystem 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, individuals, care providers, communities and researchers should have 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 also enable lower healthcare costs, improved population health, truly empower consumers and drive innovation."

The report looks at three, six and 10-year intervals with goals the agency hopes will be in place by the end of each time period.

Three years from now, the goal is to have established a nationwide "interoperability roadmap" based on the Health Information Technology for Economic and Clinical Health (HITECH) Act to support transformation of healthcare to a more person-centered, less wasteful and higher-quality system. 

Emphasis also should be placed on systems that support "query-based health information exchange, or the ability to appropriately search for and retrieve health information, in addition to point-to-point information sharing."

Within six years, the goal is to have enough of an interoperable infrastructure in place so that "care providers, such as those in schools, ambulances and prisons will be able to appropriately exchange and use relevant health information."

"Remote monitoring will be enabled through better interoperability between medical devices, home-monitoring tools and health information technology, including EHRs. Multi-payer claims databases, clinical data registries and other data aggregators will incrementally become more integrated as part of an interoperable technology ecosystem," the report adds. "Healthcare providers will also be able to aggregate and trend information within and across groups of patients based on information from multiple data sources to monitor health disparities and quality improvement opportunities (population health management)."

By year 10, the ONC envisions a health IT infrastructure that allows for more person-centered outcomes through the sharing of all types of data. "Health IT systems will enable both analysis of aggregated data and use of local data at the point of care through targeted clinical decision support (CDS). CDS will improve care by taking into account information such as an individual’s genetic profile, local trends in disease prevalence, antibiotic resistance, occupational hazards and other factors."

As an example of the trends that will help drive healthcare IT by 2024, the ONC envisions an environment where "individuals manage information from their own electronic devices and share that information seamlessly across multiple electronic platforms as appropriate," and where "primary care providers can select effective medications for patients with certain conditions based on their genetic profiles and results of comparative effectiveness research."

Getting to this point will not be easy, so the ONC recommends that all stakeholders, including the ONC itself, need to advance core technical standards for terminology and vocabulary, content and format, transport and security; develop appropriate certification standards for IT products and services; develop solutions to address weaknesses and gaps in privacy protections; work with employers, federal agencies, and private payers to define the role of health IT in new payment models that will remove the current disincentives to information exchange; and continue to establish a governance mechanism for the nationwide health information network which would be a "continually expanding ecosystem of electronic exchange activities and network service providers across the nation that rely on a set of standards, policies, and services to meet electronic exchange needs including the privacy, security, and appropriate use of the information exchanged."