ONC publishes EHR interoperability plan

As electronic health records continue to evolve alongside the health care industry's attempts at comprehensive reform, various federal agencies have attempted to codify regulations regarding the interoperability of EHR systems. While the technology can help physicians capture data more quickly and access patient information from remote locations, such limited functionality is not making the most of the potential EHR software holds.

According to David Brailer, M.D., Ph.D., former head of the Office of the National Coordinator for Health Information Technology, EHR systems can be much more than specialized computer interfaces for medical professionals.

"A physician using a computer is not [the best possible use of EHR systems]," Brailer told the Journal of the American Health Information Management Association.

Brailer's old agency holds the same opinion. The ONC recently published a 13-page proposal of how it plans to approach the problem of EHR interoperability. By connecting data and making it easier to transfer across hospital networks, the ONC hopes that EHR software can become an analytical tool that improves patient outcomes.

ONC plans on 5 areas
According to the proposal, the ONC plans to achieve a measurable degree of interoperability throughout the industry by 2024. Rather than back a general push toward interconnected and accessible data systems, the ONC plans on working together with other agencies and private organizations to reach its benchmark. 

In addition, the ONC will focus on the following five main areas as it begins to prepare EHR systems for a functional overhaul.

  1. Core technical standards and functions: The ONC, along with the Centers for Medicare and Medicaid Services, will continue to improve the base functionality required of EHR systems.
  2. Certification to support adoption and optimization of health IT products and services: Regulatory agencies will use evaluation metrics to determine which EHR systems can offer physicians the tools they need.
  3. Privacy and security protections for health information: As information becomes more easily shared, the ONC will focus on ways to restrict sensitive patient data from breaches or leaks.
  4. Supportive business, clinical culture and regulatory environment: Though clear guidelines and recommendations are necessary, the ONC's regulations will not stifle the private sector.
  5. Rules of engagement and governance of health information exchange: Centralized regulations are needed for a nation-wide system of mobile and accessible patient information.

The ONC also explained that because the road to reach true interoperability is still unclear, it plans to release more detailed guidelines in the future. The proposal stated that these would come at three-, six- and ten-year intervals, with the final deadline coming in 2024.

This initiative's focus on interoperability also dovetails with the CMS' progressing stages of meaningful use. Though no final rule has been released yet, stage 3 is expected to emphasize a move toward more accessible data. On the CMS' site for future stages of meaningful use, the agency lists patient-centered health information exchanges among its criteria for stage 3 requirements, as well as measures to improve population health. EHR systems connected to larger, remote data stores may help physicians achieve these requirements. Finally, decision support for health conditions at the national level is expected to be a component of stage 3 as well.