9 Guiding Principles For Full Interoperability

By Christine Kern, contributing writer

ONC lays out a 10-Year Vision to achieve an interoperable health IT infrastructure.

Recently, the ONC released their vision for achieving national interoperability in the Health IT infrastructure. Arguing that “achieving this goal will only be possible with a strong, flexible health IT ecosystem that can appropriately support transparency and decision-making, reduce redundancy, inform payment reform, and help to transform care into a model that enhances access and truly addresses health beyond the confines of the health care system,” the report provides nine guiding principles to success.

An interoperable health IT ecosystem makes 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 meaningfully used by recipients. It should also enable lower health care costs, improved population health, truly empower consumers, and drive innovation. For example, all individuals, their families, and care providers should be able to send, receive, find, and use health information in a manner that is appropriate, secure, timely, and reliable.

The nation has made dramatic advancements in digitizing the care delivery system during the past decade:

• Over one-half of office-based professionals and more than 8 in 10 hospitals are meaningfully using electronic health records (EHRs), which will require them to electronically exchange standardized patient information to support safe care transitions.
• One-half of hospitals are able to electronically search for patient information from sources beyond their organization or health system.
• All 50 states have some form of health information exchange services available to support care.

Here are the nine guiding principles that the ONC hopes will lead to successful implementation:

• Build upon the existing health IT infrastructure. ONC encourages building from existing structures, since Significant investments have been made in health IT across the care delivery system and in other relevant sectors that need to exchange information with individuals and care providers.
• Realize that one size does not fit all. Interoperability requires not only technical and policy conformance among networks, technical systems and their components, but also behavior and culture change on the part of users.
• Empower individuals. Health information from the care delivery system should be easily accessible to individuals and empower them to become more active partners in their health just as other kinds of data are empowering them in other aspects of their lives.
• Leverage the market. Demand for interoperability from health IT users is a powerful driver to advance our vision. As payment and care delivery reform increase demand for interoperability, health providers can work with and support these efforts.
• Simplify, simplify, simplify. Obviously, wherever possible, simpler solutions should be implemented first, with allowance for more complex methods in the future.
• Maintain modularity. Modularity creates flexibility that allows innovation and adoption of new, more efficient approaches over time without overhauling entire systems.
• Consider the current environment and support multiple levels of advancement. Individuals and caregivers have an ongoing need to find, send, receive and use their own health information both within and outside the care delivery system and interoperable infrastructure should enable this.
• Focus on value. Strive to ensure that interoperability efforts yield the greatest value to individuals and care providers; improved health, health care and lower costs should be measurable over time and at a minimum, offset the resource investment.
• Protect privacy and security in all aspects of interoperability. It is essential to maintain public trust that health information is safe and secure and achieve greater transparency for individuals regarding the business practices of entities that use their data, particularly those that are not covered by the HIPAA Privacy and Security Rules.