The Office of the National Coordinator yesterday published an important new 10-year plan to develop an interoperable health IT infrastructure across the nation. The 13-page paper describes ONC’s evolutionary vision for a “strong, flexible health IT ecosystem…that will support more efficient and effective systems, scientific advancement, and lead to a continuously improving health system that empowers individuals, customizes treatment, and accelerates cure of disease.” ONC outlined a roadmap defined by timed agendas:
Three Year Agenda that focuses on completing requirements of the HITECH Act, improving interoperability of existing health information networks, standardizing the “vocabulary and structure of essential information”(presumably including converting to ICD-10), and addressing key privacy, security, and business policy challenges to ensure secure, authorized information sharing
Six Year Agenda that will result in individuals becoming “active participants in managing their care” as contributors of information to their health records. Using information from multiple data sources, including remote monitoring, home-monitoring, and interoperable EHRs will enable care providers to “continually learn” and understand health disparities and other factors, in order to provide better population health management.
10-Year Agenda that will offer “advanced, more functional technical tools to enable innovation and broader uses of health information” supporting health research and public health. This will include targeted decision support at the point of care, and applying analyses of a wide array of aggregated information such as patient genetic profiles, local disease trends, occupational hazards, and other factors. Public health risks from disease outbreaks and disasters will be much better managed.
The plan goes into some detail on five “critical building blocks” needed to meet the above timeline, to be shared by the federal government, state, tribal, and local governments, and the private sector:
Core Technical Standards and Functions in areas such as terminology and vocabulary, content and format, transport, and security.
Certification to Support Adoption and Optimizationof Health IT Products and Services. ONC expects to leverage its Health IT Certification Program so that a “broad spectrum of health IT” conforms to the technical standards needed to capture and exchange data across the country.
Privacy and Security Protections for Health Information that “keep pace” with the expanded exchange of electronic information exchange, support distributed analytics and open evidence sharing, and protect against emerging cyber threats and the risks involved when information is shared with non-HIPAA covered entities.
Supportive Business, Clinical, Cultural, and Regulatory Environment. ONC will pull together 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 remove barriers to data flow. ONC also plans to employ collaborative initiatives to educate consumers on managing their own healthcare, including encouraging providers to do consistent marketing and messaging to offer patients access to their health information.
Rules of Engagement and Governance of Health Information Exchange, which will continue to be managed by ONC, as defined by the HITECH Act. Governance of the “continually expanding ecosystem of electronic exchange activities” across the nation will rely on a set of standards, policies and oversight to “facilitate trust and interoperability across all the diverse entities and networks” involved in information exchange about individuals and their health information.