New Roadmap for Interoperability Hopes to Improves National Healthcare Integration Strategy

The Office of the National Coordinator for Health Information Technology (ONC) has released an Interoperability Roadmap[1]—a federal guidebook to outline the path forward to national integration and coordination of healthcare information. Titled “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Draft Version 1.0,” this document outlines the need to shift healthcare interoperability to a goal of more person-centered care outlining two primary reasons[2]:

  1. “Health care is being transformed to deliver care and services in a person-centered manner and is increasingly provided through community and home-based services that are less costly and more convenient for individuals and caregivers; and
  2. Most determinants of health status are social and are influenced by actions and encounters that occur outside traditional institutional health care delivery settings, such as in employment, retail, education and other settings.”

This idea of person-centric care is often discussed as an essential component of improving behavioral and mental health, making this roadmap of strong interest to providers in this space.

The roadmap lays out a plan with goals to fit a 3, 6 and 10 year timeframe. In the short-term, it lays out guiding principles that should be incorporated into interoperability initiatives including:

  • Build upon existing health IT infrastructure
  • Maintain modularity
  • One size does not fit all
  • Consider the current environment and support multiple levels of advancement
  • Empower individuals
  • Simplify
  • Protect privacy and security in all aspects of interoperability
  • Leverage the market
  • Focus on Value
  • Scalability and universal access[3]

While the Roadmap recognizes it is not realistic to assume all health information needs will be met with a single electronic health information sharing approach, it does call for the standardization of data elements and call for actions “that will enable a majority of individuals and providers across the care continuum to send, receive, find and use a common set of electronic clinical information at the nationwide level by the end of 2017.”[4]

The Roadmap cites 4 actions as most important for establishing nationwide interoperability of electronic health information through health IT in the near term. These actions include:

  1. Establish a coordinated governance framework and process for nationwide health IT interoperability
  2. Improve technical standards and implementation guidance for sharing and using a common clinical data set
  3. Enhance incentives for sharing electronic health information according to common technical standards, starting with a common clinical data set
  4. Clarify privacy and security requirements that enable interoperability[5]

Will it work?

So is the plan outlined in the roadmap realistic? A recent article showed a consensus of opinions that tended to agree that the document was a good start, but raised certain key questions. As reported in HealthcareDIVE, according to Jeff Loughlin, Program Director of the Massachusetts eHealth Collaborative: “The new principle for interoperability now tries to identify both functional and business requirements, recognizing that one size does not fit all, and allows for increased modularity. This should better allow the market to help drive the improvement and innovation process.”[6]

But Loughlin highlighted challenges to this new model for interoperability as he explained, “We need to start to think a little more holistically about patient care, and that it doesn’t necessarily stick to state lines. The states obviously have the right to design their own procedures to manage [data flow], but interoperability comes into play because organizations have to be able to send information across state lines to follow clinical care or business requirements, and we can’t always let state or local governments dictate how that happens.”[7]

A representative for a health IT vendor had a slightly different perspective. Jeff Lin, Senior Vice President of Product Management for InstaMed, stated, “There are some definite positives here, for instance, with the technical consistencies, the plans for developing a common language.” But he also added, “The big question I have is ‘How do you drive the consumer engagement?’ Interoperability is all about sharing information. What’s the incentive for the consumer to share this information?”[8]

“The [consumer engagement piece is] important because that’s what’s going to drive providers and payers to work toward a common language,”[9] he continued.

While it doesn’t solve everything in one document, the Roadmap at least keeps moving the ball forward in the effort to gain a national consensus not only on the importance of healthcare interoperability, but how to put together an effort to realistically achieve it.


[1] “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap DRAFT Version 1.0,” http://www.healthit.gov/sites/default/files/nationwide-interoperability-roadmap-draft-version-1.0.pdf

[2] “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap DRAFT Version 1.0,” pg. 8, http://www.healthit.gov/sites/default/files/nationwide-interoperability-roadmap-draft-version-1.0.pdf

[3] “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap DRAFT Version 1.0,” pg. 9, http://www.healthit.gov/sites/default/files/nationwide-interoperability-roadmap-draft-version-1.0.pdf

[4] “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap DRAFT Version 1.0,” pg. 10, http://www.healthit.gov/sites/default/files/nationwide-interoperability-roadmap-draft-version-1.0.pdf

[5] “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap DRAFT Version 1.0,” pg. 11, http://www.healthit.gov/sites/default/files/nationwide-interoperability-roadmap-draft-version-1.0.pdf

[6]  Marisa Torrieri, “The Interoperability Roadmap: A Good Foundation with Unanswered Questions?” HealthcareDive, (February5, 2015), http://www.healthcaredive.com/news/the-interoperability-roadmap-a-good-foundation-with-unanswered-questions/360640/

[7] Marisa Torrieri, “The Interoperability Roadmap: A Good Foundation with Unanswered Questions?” HealthcareDive, (February5, 2015), http://www.healthcaredive.com/news/the-interoperability-roadmap-a-good-foundation-with-unanswered-questions/360640/

[8] Marisa Torrieri, “The Interoperability Roadmap: A Good Foundation with Unanswered Questions?” HealthcareDive, (February5, 2015), http://www.healthcaredive.com/news/the-interoperability-roadmap-a-good-foundation-with-unanswered-questions/360640/

[9] Marisa Torrieri, “The Interoperability Roadmap: A Good Foundation with Unanswered Questions?” HealthcareDive, (February5, 2015), http://www.healthcaredive.com/news/the-interoperability-roadmap-a-good-foundation-with-unanswered-questions/360640/

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