December 6, 2021
According to HealthIT.gov, “The Office of the National Coordinator for Health IT (ONC) is responsible for advancing connectivity and interoperability of health information technology (health IT).” But what exactly is interoperability and how does the ONC pursue this? Section 4003 of the 21st Century Cures Act provides some context for what criteria health information technology needs to meet to be considered interoperable:
“(A) enables the secure exchange of electronic health information with, and use of electronic health information from, other health information technology without special effort on the part of the user;
(B) allows for complete access, exchange, and use of all electronically accessible health information for authorized use under applicable State or Federal law; and”
(C) does not constitute information blocking as defined in section 3022(a).”
In reference to the third criterion, the Public Health Service Act states that information blocking is a practice that “is likely to interfere with, prevent, or materially discourage the access, exchange, or use of electronic health information.”
In May of 2021, the public submitted their thoughts and feedback on what the future of interoperability in healthcare should look like in 2030. Submissions came via Twitter, video, and on HealthIT.gov. Office of the National Coordinator for Health Information Technology (ONC) took these submissions and created general statements for what Health Interoperability Outcomes individuals wanted to see without specifying exactly how they would be achieved.
The outcomes were grouped into one of two categories: Individual and Care Delivery Experiences or Health System Experiences. An example of a Health Interoperability outcome from the Individual and Care Delivery Experiences category is: “Individuals will have internet-based access to their past and present electronic health information from clinical and administrative sources.” The following is an example from the Health System Experiences category: “The data used for clinical and administrative processes will be electronically integrated to support decisions about payment, eligibility, and benefits.”
Patient-related goals include increasing internet access to past and present electronic heath records (EHR) and facilitating access to care without the patient having to provide their health information. Individuals will also be able to monitor and control how their health data is accessed and who accesses it. Additionally, individuals should have the option to receive home healthcare for various reasons.
Both patients and providers will benefit from being able to compare online healthcare and prescription costs online. Internet-based tools and apps will be used to manage EHR interoperability with providers in lieu of paper forms; all relevant care data will be electronic. This will facilitate healthcare providers integrating external electronic data into their systems.
The ONC 2030 Interoperability’s impact on health professionals will include reduced administrative burdens and more direct patient care time. EHR data will be easily accessible to aid provider decision making about payment, eligibility, and benefits. Health Interoperability Outcomes from ONC 2030 Interoperability also mention that there will be reduced diagnostic test and procedure duplication.
In terms of software Health Interoperability Outcomes, services will be available to combine with electronic health records; this will expedite clinical decision making. Another outcome that will benefit this decision making is that providers will be able to search and access information within a workflow and see it presented in relevant, intelligent ways.
ONC Interoperability 2030 does have some drawbacks to consider. Concern for patient data safety and security accompanies the shift to fully electronic, easily transferrable data. Supporting interoperability software that will achieve ONC 2030 Interoperability outcomes is also costly and can deter services such as patient access management from receiving as much fiscal support. With full shift to electronic health information brings up questions about how patients within older populations or those who are uneducated with technology will be able to easily access data to achieve the outcomes intended to benefit them.
ONC 2030 Interoperability projection benefits are visible in the Health Interoperability Outcome themes. These include the aim to decrease administrative burdens and financial costs for both physicians and patients. Another theme is the aim to improve clinicians’ and patients’ informed decision making via improved software and widespread access to EHRs. In short, the outcomes revolve around cultivating connectivity to improve patient-centered care.