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ONC unveils step toward ‘interoperability for all’


Proposed Trusted Exchange Framework aims to make sharing healthcare data a clearer reality.

Acknowledging the challenges that exist in sharing healthcare data-but also some initial success-federal regulators believe they have a plan to boost interoperability.

Office of the National Coordinator for Health Information Technology (ONC) has released a draft for the Trusted Exchange Framework, a set of technical specifications intended to help move the healthcare industry toward more efficient and effective data exchange for patients, physicians and payers.


RELATED READING: There needs to be accountability for the lack of interoperability


The framework is a requirement of the 21st Century Cures Act, and one of several initiatives created by Congress to improve the flow of healthcare information.

In announcing the proposed framework, ONC chief Don Rucker, MD described it as a “network of networks” concept that will help connect existing entities and allow them to exchange information. The framework does not specifically address the provider level, such as allowing one provider to access information from another provider, but will allow networks using the proposed framework to more easily exchange information using an agreed upon standard. There are other rules in process that will directly address topics like information blocking and open application programming interfaces (a set of rules on how software interacts and provides information to other software).

Genevieve Morris, ONC’s principal deputy national coordinator for health information technology, says they want to establish a single “on-ramp” to interoperability, where a provider can log into one network and get all the patient data they need from any other network. Just like users of different cell phone networks can exchange calls and data with each other, Morris says the same thing should be possible in healthcare.

Next: What the proposed framework means for HIPAA


According to ONC, the draft framework will be available until February 18 for public comment. Once the comments are evaluated, ONC will choose a Recognized Coordinating Entity-essentially an industry organization that will use the framework to develop a common agreement that health networks and their participants will voluntarily agree to adopt. The final agreement will be released for public comment with the goal of having the final rule approved and published this year.

The draft framework was based on existing health networks and their agreements, and was created to establish a minimum number of steps that must be done to facilitate information exchanges between networks. “We are using technology and servers that exist,” says Rucker. “This is not something of necessity where we need a totally different infrastructure. This is the root goal of the Trusted Exchange Framework-to reuse as much is out there as possible.”


FURTHER READING: It's time for everyone to stop talking interoperability and actually achieve it


Rucker says that the proposed framework does not change current HIPAA requirements or protections, and Morris notes that every effort was made to protect patient data through several security protocols. ONC has also released guidelines to identify a path toward broadening the data that can be exchanged via the framework.

“The draft Trusted Exchange Framework we issued today reflects the successes and challenges already existing in the exchange of health information and is designed to help guide the nation on its path to interoperability for all,” says Rucker. “The principles and direction we released today, combined with the support of providers, existing health information networks, health IT developers, and federal agencies, are designed to help improve patient care, care coordination, and the overall health of the nation.”

The draft is available at www.healthit.gov, and comments can be submitted at exchangeframework@hhs.gov .

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