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ONC unveils proposal for health IT interoperability


Paper outlines vision for “learning health system,” making data accessible and useful to providers and patients

By 2024, the nation’s health information technology (IT) will enable care providers, patients, researchers, and communities to exchange and use health data so as to continuously learn and advance the goal of improved healthcare.

That goal is laid out in

a recent paper

from the Office of the National Coordinator for Health Information Technology (ONC). The “learning health system” the paper envisions should “enable lower healthcare costs, improved population health, truly empower consumers, and drive innovation,” ONC says.

The paper says the overall goal can be achieved through a series of interim steps throughout the next decade. Over the next three years ONC will:

  • Use the existing health IT infrastructure to help make healthcare more patient-centered, less wasteful, and higher quality, by improving the interoperability of existing health information networks and scaling up existing methods for exchanging health information across vendor platforms. “Ensuring that individuals and care providers send, receive, find, and use a basic set of essential health information…will enhance care coordination and enable health system reform to improve quality care,” the paper states.

  • Further standardize the “vocabulary and structure” of health information, including data provenance, quality and reliability, and patient matching to improve the quality of interoperability.

Goals during the next six years include:

  • Enabling patients, care providers, and pubic health departments to send receive, find, and use an expanded set of health information to support team-based care. Remote monitoring will be made possible through better interoperability among medical devices, home monitoring tools, and electronic health records (EHRs).

  • Enabling healthcare providers to aggregate and trend information within and across patient populations based on information from multiple data sources to monitor health disparities and identify quality improvement opportunities.

Next: The five building blocks for achieving interoperability


By 2024, the paper says, “the nation’s health IT infrastructure will support better health for all through a more connected healthcare system and active individual health management. Information sharing will be improved at all levels of public health, and research will better generate evidence that is delivered to the point of care.”

Achieving the vision will depend on what the paper calls “five critical building blocks.” These include:

  • Core technical standards and functions,

  • Certification to support adoption and optimization of health IT products and services,

  • Privacy and security protections for health information,

  • Supportive business, clinical, cultural, and regulatory environments, and

  • Rules of engagement and governance


Tom Giannulli, MDHealth IT industry observers and participants support ONC’s vision, but wonder if the agency will be able to achieve it. “I believe their objectives are correct,” says Tom Giannulli, MD, chief medical information officer for Kareo, an EHR vendor. “The value is locked up in the data. And rather than just putting data into a computer they’re asking how do we aggregate the data, analyze it, and feed it back to the provider in a meaningful way?”

Giannulli adds, however, that his confidence in ONC’s ability to realize the goal is “somewhat minimized” by the lack of success thus far in meeting objectives of the second phase of the meaningful use program. “Without the momentum (from meaningful use) can they really get to the next step? That’s the big question in my mind,” he says.

“I think the idea of creating a learning health system, where we can share information throughout the country on what’s working, and get the information out there quicker, is really going to be beneficial,” says Harry Rhodes, MBA, director of health information management practice excellence for the American Health Information Management Association (AHIMA).

The main challenge, Rhodes says, will be arriving at a consensus on standards in areas such as security and semantic interoperability. “AHIMA’s been involved in standards initiatives for many years, and it moves very slowly,” he says.





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© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health