ONC’s Look Ahead to “An Interoperable Health IT Infrastructure” Within 10 Years

by Leonardo M. Tamburello

The Office of the National Coordinator for Health Information Technology (ONC) had released an ambitious “concept paper” setting forth its “10-Year Vision to Achieve An Interoperable Health IT Infrastructure.”  The goal is to “make the right data available to the right people at the right time across products and organizations in a way that can be relied upon and used by recipients.”  ONC has identified three, six, and ten-year agendas towards this objective.

Though HIPAA’s implementation in 1996 and certified meaningful use of certified electronic health record technology (CEHRT) has led to impressive advancements in technological innovation, ONC’s ten-year vision promises even more changes yet to come.

Extraordinary leadership will be required of ONC in collaboration with state and local governments, as well as the private sector.  To achieve this, ONC has identified “five critical building blocks” upon which to focus its efforts:

  1. Core technical standards and functions which build upon existing health IT (HIT) infrastructure;
  2. Certification to support adoption and optimization of health IT products and services;
  3. Privacy and security protections for health information greater transparency for individuals regarding the business practices of entities that use their data, even those users are not specifically covered under the HIPAA Privacy and Security Rules;
  4. Supportive business, clinical and regulatory environments;
  5. Rules of engagement and governance.

Within three years, ONC intends to further standardize the vocabulary and structure of essential information, as well as address critical issues such as data provenance, data quality and reliability, and patient matching.  All of these efforts aren’t year towards improving the quality of interoperability and facilitating a vastly increased quantity of information which is captured by HIT infrastructure.  Simultaneously, a “common framework to enhance trust” will be implemented by addressing key privacy, security, and business policy and practice challenges related to the secure exchange of health information across existing networks.  In addition ONC intends to advance policy and programmatic stimuli to encourage the use of this information in a manner which supports care delivery reform, improves quality, and lowers costs.

Within six years, by 2020, ONC envisions that individuals, care providers, and public health departments will send, receive, find and use an expanded set of health information across the entire industry in support of “team-based” care. By this time, interoperability between CEHRT and medical devices will enable remote monitoring from virtually any location, including homes, schools, and workplaces.  Data aggregation will give rise to “multi-payer” claims databases and clinical data registries.  Using this information, providers will be able to aggregate and trend information within and across groups of patients, and payers (including Medicare and Medicaid) will be able to implement value-based payment systems based on clinical analyses.

In 10 years, according to this ONC report:  information sharing will be standardized and improved all levels of public health, enabling patient-centered research to be better targeted, and individuals will , be able to manage information from their own mobile devices and share that information seamlessly across multiple electronic platforms, such as healthcare providers, social service agencies, and consumer-facing applications.  In addition, these data will enable public health surveillance and retrospective analyses on an unprecedented level.

ONC’s roadmap depends on continued support and engagement from all healthcare stakeholders who are encouraged to be active participants in shaping the decisions which will define this industry for years to come.