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The February HIT Standards Committee was a joint meeting with the HIT Policy Committee to align the policy and technology work ahead in 2015.
Erica Galvez began the discussion by reviewing the recently published Interoperability Roadmap. She first highlighted supportive business, clinical, cultural and regulatory environments.
On January 26, HHS and CMS announced that they are aiming to have 30 percent of Medicare fee-for-service payments tied to quality or value through alternative payment models by the end of 2016,and 50 percent of payments by the end of 2018. Requirements for participants in these new models can reinforce interoperability. Near term actions for the Federal government include linking policy and funding activities beyond Meaningful Use to adoption and use of certified health IT and electronic information sharing according to national standards. Near term actions for state government include a “call to action” to use available levers and Medicaid purchasing power to expand upon existing efforts to support interoperability and explore new options. Near term actions for non-government payers/purchasers include a “call to action” to explore financial incentives and other ways to emphasize the interoperable exchange of health information among provider networks.
Erica continued with a discussion of governance, emphasizing the need for a framework than a new organization with “top down” authority.
She then continued with an overview of privacy and security protections for health information including the need to address the variation in state rules which make it difficult to build software systems that accurately capture, maintain, and persist consent data. ONC’s role is to help facilitate the alignment of policy among all stakeholders.
We then discussed the core technical standards/functions and certification/testing to support adoption and optimization of health IT products and services. Near term actions include ONC’s effort to publish annual list of best available technical standards for core interoperability functions.
The private and public sectors must define a common clinical data set to achieve semantic interoperability, constrain implementation of the C-CDA, advance standards for data provenance at the document and data element
level, advance standard, and open RESTful APIs to support simple, scalable interoperability.
Erica concluded with a discussion of the next steps. Workgroups were assigned sections of the roadmap to review to make the best use of resources and avoid overlap.
Steve Posnack continued with an overview of the recently published Standards Advisory document. The goals of the Advisory are to be specific about the best standards available for each purpose. It’s a non-regulatory approach with an interactive, predictable process. Hopefully it will be a widely vetted resource that will enable a “look first” philosophy for government programs, procurements, testing or certification programs, and standards development.
Steve then provided a Certification Program update including plans for quality improvement, greater transparency, increased collaboration, and improved customer service.
A great meeting with many next steps. It’s clear that interoperability will significantly increase when the right standards, supported by constrained implementation guides, are paired with consent/security policies widely accepted by all stakeholders.
John Halamka, MD, is the Chief Information Officer of Beth Israel Deaconess Medical Center and blogs at Life of a Healthcare CIO.