Nationwide Interoperability Roadmap. Steve Posnack, MS, MHS September 12, 2014

Transcription

1 Nationwide Interoperability Roadmap Steve Posnack, MS, MHS September 12, 2014

2 Interoperability Formally: The ability of two or more systems or components to exchange information and to use the information that has been exchanged. IEEE Standard Computer Dictionary(New York, NY: 1990) Updated: Ability of a system or product to work with other systems/products without special effort on the part of the customer. Interoperability is made possible by the implementation of standards. (Definition from IEEE, dards_glossary.html) In simple terms: All individuals, their families, and their health care providers have appropriate access to health information that facilitates informed decision-making, supports coordinated health management, allows patients to be active partners in their health and care, and improves the overall health of our population.

3 10 Year Interoperability Vision Leverage health IT to increase health care quality, lower health care costs and increase population health Focus on supporting health broadly, including but not limited to health care delivery Build incrementally over time from current technology multiple methods of exchange required Establish best minimum possible interoperability for all; create opportunities for innovation Empower and maintain focus on individuals

4 Milestones and Building Blocks 2017 Ensure providers and individuals can send, receive, find and use a basic set of essential health information 2020 Expand sources and users of information Continue improving quality and lowering cost Increase automation Scale broadly Core technical standards and functions 2024 Precision medicine Reduce time from evidence to practice Virtuous learning cycle (learning health system) Certification to support adoption and optimization of health IT products & services Privacy and security protections for health information Supportive business, clinical, cultural, and regulatory environments Rules of engagement and governance

5 The Learning Health System Examples Individuals manage information from their own electronic devices and share that information seamlessly across multiple electronic platforms as appropriate (health care providers, social service providers, consumer-facing apps and tools, etc). Primary care providers can select effective medications for patients with certain conditions based on their genetic profiles and results of comparative effectiveness research. Individuals, care providers, public health and researchers contribute information and learn from information shared across the health IT ecosystem, with rapid advancement in methods for deriving meaning from data without sharing PHI.

6 Nationwide Interoperability Roadmap ONC committed to leading the development of a shared, national interoperability roadmap in the 10 year concept paper Companion document to vision paper that focuses on chartering a course toward the vision Includes, but not limited to federal government Will adhere to guiding principles in the vision paper Structure will be based on the vision, building blocks, and milestones described in the vision paper

7 Why a Nationwide Roadmap? A roadmap provides a path forward; everyone can rally behind it; collectively update it over time We anticipate the roadmap addressing things like: What are the critical technologies and policies (including governance) required to achieve the vision? Who needs to do what and by when? (including government, technology developers, technology users) How will the roadmap be updated over time and at what frequency?

8 Building Block 1: Core technical standards and functions Core technical standards for: terminology and vocabulary content and format Transport Security Common services/functions likely required regardless of specs for transport and format of data: 1. Methods to accurately match individuals, providers and their information across data sources 2. Directories of the technical and human readable end points for data sources so they and the respective data are discoverable 3. Methods for authorizing users to access data from the data sources 4. Methods for authenticating users when they want to access data from data sources 5. Methods for securing the data when it is stored or maintained in the data sources and in transit, i.e., when it moves between source and user 6. Methods for representing data at a granular level to enable reuse 7. Methods for handling information from varied information sources in both structured and unstructured formats

9 Building Block 2: Certification to support adoption and optimization of health IT products & services Certification program to date has focused largely on testing standards conformance interoperability testing needed? What degree of testing is adequate? Modularity Broader array of health care settings LTPAC, BHC, beyond MU

10 Building Block 3: Privacy and security protections for health information Fair Information Practice Principles Data provenance Consent management Identity management, authorization, authentication Individual access Transparency

11 Building Block 4: Supportive business, clinical, cultural, and regulatory environments Policy and funding levers for care delivery Awareness among consumers and providers Culture change

12 Building Block 5: Rules of engagement and governance Lack of trust may be the single biggest barrier to interoperability Focus on rules of the road for information flow across networks Operationalize common trust framework

13 Guiding Principles Examples of Tension Build upon existing health IT infrastructure One size does not fit all Empower individuals Leverage the market Simplify Maintain modularity Consider the current environment and support multiple levels of advancement Focus on value Protect privacy and security in all aspects of interoperability

14 Overview of Roadmap Process & Timeline Initial roadmap development Oct 2014 Online community forum Ai reports Federal workgroups State engagement FACA workgroups FACA review and recommendations Address recommendations from: Governance sub-workgroup JASON task force Mitre reports Jan 2015 Roadmap for public comment Synthesize and update based on public input Mar 2015 Roadmap version 1.0

15 Nationwide Interoperability Roadmap Online Forum ONC launched an online forum with a general solicitation for input Asking for input on: Priorities Use cases (to id and validate requirements) Critical actions within each of the building blocks