The Department of Health and Human Services (HHS) today published a 10-year roadmap on how healthcare facilities and patients should be able to share medical information.
The report came from HHS's Office of the National Coordinator for Health Information Technology (ONC), and coordinates public and private sector efforts to advance the secure exchange of electronic health record (EHR) information across the U.S. The goal is to improve healthcare.
The plan defines efforts to improve the nation's healthcare system through the use of interoperable health information technology, including a focus on person-centered and self-managed care and an overall improvement of outcomes.
"In order for us to be able to understand the quality of care delivered for individuals and for populations, we need to have that data available," said Dr. Karen DeSalvo, the national coordinator for health IT.
The roadmap includes a common clinical data set for every patient. That data set includes information such as the patient's name, sex, date of birth and background information such as vital signs, smoking status, immunizations, medical problems and medications and allergies. The clinical data set would also include a physician's care plan, along with patient goals and instructions, care team members and any future procedures along with a notes and narrative section.
Currently, hospital systems have proprietary methods for sharing patient data, if they have any electronic data sharing system at all. Some hospital systems have adopted de facto industry standards, such as the Health Level Seven International (HL7) standard and guidelines for sharing information.
Other healthcare facilities share data through government sponsored Health Information Exchanges (HIEs), where doctors, nurses, pharmacists, other healthcare providers and patients can access and securely share medical information. However, the rollout of HIEs has been sporadic at best.
Adding to the problem has been the active blocking of data sharing between organizations. The data blocking occurs through vendors who keep their software proprietary and unable to exchange data, or by actively blocking protocols that would otherwise allow it. Thus, vendors can corner their respective markets.
"We believe we're all going to have to agree that, No. 1, consumers should have access to their electronic health information when and where it matters to them and they should be able to share that information where they want," DeSalvo said.
"Secondly, that we would not engage knowingly or unreasonably in health information blocking, and third that we'd all move to federally recognized, national interoperability standards...that would include privacy and cyber security standards," she said.
The Roadmap draft policy was originally published in January and allowed for months of comment and feedback from hundreds of health and health IT experts from across the nation through an online forum.
The final roadmap lays out ways to improve technical standards and has implementation guidance for priority data domains. In the near-term, the roadmap focuses on using commonly available standards, while pushing for new standards and technology approaches, such as the use of application programming interfaces (APIs) for sharing patient information.
The plan emphasizes the need to build on the technology and investments made already, while continuing to seek ways to support innovation and move beyond EHRs as the sole data source to a wide range of health information technologies used by individuals, providers and researchers.
The roadmap calls for rapidly shifting and aligning federal, state and commercial payment policies from fee-for-service to value-based models to stimulate the demand for interoperability. And it clarifies and seeks to align federal and state privacy and security requirements that enable interoperability.
The roadmap lays out three, six and 10-year goals for collaboration among public and private healthcare providers to achieve information interoperability.
From 2015 through 2017, the plan outlines how to send, receive, find and use priority data domains to improve healthcare quality and outcomes.
From 2018 through 2020, the plan outlines how to expand data sources and users in an interoperable health IT ecosystem to improve healthcare and lower costs for it.
From 2021 through 2024, the plan outlines how to achieve nationwide interoperability to enable a learning healthcare system.
"This Roadmap has been developed in partnership with the private sector and provides a clear, strategic approach to see that we successfully achieve seamless interoperability by creating the right financial incentives, establishing shared and explicit standards, and developing a trusted environment for data flow that enables patients to make their health records accessible anywhere they choose to seek care," DeSalvo said.