ONC unveils Final Interoperability Roadmap: 10 things to know

The ONC released its final guidance Tuesday on how it plans to make the American healthcare system fully interoperable within the next 10 years.

This is the structure of the ONC's final Interoperability Roadmap:

2015-2017: Send, receive, find and use priority data domains to improve healthcare quality and outcomes.

2018-2020: Expand data sources and users in the interoperable health IT ecosystem to improve health and lower cost.

2021-2024: Achieve nationwide interoperability to enable a learning health system, with the person at the center of a system that can continuously improve care, public health, and science through real-time data access.

Here are 10 additional things to know about the ONC's report.

1. In the new report, ONC reiterated an announcement made along with the Interoperability Roadmap draft in January regarding the move towards value-based payments. This announcement stated that by the end of 2016, CMS is aiming to administer 30 percent of all Medicare payments to providers through alternative payments models that reward quality and value and encourage interoperability. By the end of 2018, it will seek to do so for 50 percent of all Medicare payments. By 2024, CMS will use value-based payment models as the dominant mode of payments to providers.

2. CMS says it will take advantage of opportunities to build interoperability requirements into relevant payment rules and programs while also encouraging states with Medicaid managed care programs to include health IT and HIE strategies on the state-level. This will be done with the goal of enabling health-related stakeholders at the clinical level and beyond to have appropriate access to relevant data by 2020.

3. ONC included a call to action for technology developers to provide the necessary services to support delivery system reform for healthcare needs. This call to action also extends to health IT users to provide feedback to both the government and vendors.

4. By the end of 2020, ONC is aiming to have standards developing organizations agree on semantic standards, such as vocabulary and data set, for health data domains. ONC says it will promote and participate in collaborative processes to help align these standards.

5. The report says that by 2020, more than 50 percent of technology developers will provide access to electronic health information through standard, public application programming interfaces. This number will rise to more than 75 percent by 2024. ONC will work with stakeholders to develop and disseminate best practices for new API requirements and certifications.

6. By 2020, providers will be equipped to self-test their deployed health IT for interoperability to ensure technology operates as expected before and after implementation. By 2024, a comprehensive testing structure will exist so that new IT can be continuously tested for interoperability.

7. ONC will dedicate time to work with organizations such as the National Institute for Standards and Technology to develop rigorous testing processes.

8. By 2017, the ONC is aiming to have all organizations that match EHRs have an internal duplicate record rate of no more than 2 percent. By 2020, this number should drop to 0.5 percent and by 2024, 0.1 percent.

9. Technical standards for Basic Choice and Granular Choice in regards to patient consent and privacy will be implemented by 2020 and 2024, respectively. In light of this, ONC recommends most states conduct an assessment of their health privacy laws to determine HIPAA alignment.

10. By the end of 2020, the ONC aims to have individuals able to regularly access and contribute to their EHR, sending and receiving information electronically to manage their care. By 2024, the ONC says individuals should be able to seamlessly integrate and compile longitudinal electronic health data across online tools and mobile platforms. To make this a reality, the ONC is encouraging providers and developers to include individuals and caregivers in the process of creating and implementing health IT.

The report included an overview of feedback ONC received based on the January draft of the Interoperability Roadmap. There was general agreement on interoperability requirements set forth at the time, but some disagreement about the details, including mixed feedback on governance approach, desire for more clarity on standards direction, a call for a unique health identifier, confusion about some privacy and security concepts and recommendations for roadmap restructuring.

Included at the end of the report are statements of support from representatives of the Department of Defense and the National Institutes of Health. The ONC also reports private sector endorsements of their Interoperability Roadmap from AHIMA, athenahealth, Cerner, CHIME, McKesson, HIMSS and Commonwell Health Alliance, among other organizations.

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