ONC 2022 agenda: Interoperability

With COVID-19 putting unimaginable stress on the healthcare ecosystem, interoperability and data access have never been more important. Unfortunately, the care continuum still struggles with walls, gaps, siloes, and other obstacles that have made it difficult for providers and patients to gather the insights they need to manage the pandemic effectively.

“The pandemic has stress-tested our health IT infrastructure in ways that no alpha and beta testing ever could,” said National Coordinator for Health IT Micky Tripathi, MD. “It has shown a lot of things that worked and a lot of bare spots.”

“As we move into the next phase of the health crisis, however, we have the opportunity to re-conceive the value chain and transform our health delivery system into one that is fundamentally digitally native.”

The goal of the Office of the National Coordinator (ONC) is to create an interoperable health system that allows the market, including patients, to aggregate and access information in ways that will generate value for individuals and at large, Tripathi said.  

“We need a system that’s flexible and resilient, not brittle, so we don’t have to rip and replace in decades-long cycles,” he stated. “That’s how the rest of the internet economy works, and we need to catch up.”

Tripathi laid out five major areas of focus for the ONC as the nation moves forward in 2022 and beyond.

Enforcing the information blocking rule

The controversial rule is a complement to HIPAA, Tripathi explained. “HIPAA says you’re permitted to share data as a regulated entity, but it doesn’t say you have to. The information blocking rule says you’re obligated to share data in specific ways if you don’t want to get fined.”

“This allows us to compete on the value that data brings, not just on being the person who holds the data.”

Expanding adoption of standardized APIs

This year, Certified EHR Technology (CEHRT) vendors are required to offer a FHIR-compliant version of their APIs that can handle the USCDI, the minimum dataset required by federal authorities. Tripathi emphasized that this API must be fully developed and actively available to customers by the end of the calendar year.

Implementing TEFCA for coordinated interoperability

TEFCA was released earlier this year, and the industry is currently awaiting the next steps. 

“It’s taken us a long time to get to this point, but we shouldn’t understate how much progress has been made along the way,” Tripathi said. “TEFCA will let us build on that with new guidelines and new use cases, such as public health, payment, and operations. We’re hoping it will rapidly pull the industry forward.”

Promoting health equity by design

Health equity is enormously important, and digital data plays a huge role in helping marginalized communities access health services. The ONC will ensure that stakeholders are being intentional about their thinking in terms of health equity and the social determinants of health.

“We do privacy and security by design; we do safety by design. We need a similarly structured approach for equity so it’s not just an afterthought or an add-on,” Tripathi said.

Coordination between federal agencies

“The federal government isn’t doing the best job it could with modeling the kind of behavior we want from the industry,” Tripathi admitted. The ONC will be taking on a larger role as a coordinator of federal departments to align regulations, reduce red tape, and create easy-to-understand, shared standards going forward.

Despite the challenges that lie ahead as providers and regulators work together to achieve greater interoperability, Tripathi closed his remarks on an optimistic note.

“This is a moment to appreciate where we are and imagine where we can go,” he concluded. “We have an incredible opportunity to think really hard about how we’re going to give our best to our patients, our business partners, and our country, and we’re excited to move forward together.”

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• Maximizing the ROI of investments in healthcare digital transformation tools
• In a COVID-19 world, digital transformation of the workforce goes beyond clinical tools
• Embedding DEI initiatives into healthcare talent recruitment
• Building virtual care infrastructure begins with removal of perceived barriers
• Sutter Health staying agile to improve patient experience with digital automation
• Mayo Clinic is using AI to solve the unstructured data problem for all

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.