Last month, I attended a health information exchange bonanza: the 5th annual Strategic Health Information Exchange Collaborative (SHIEC) conference and the 3rd annual Interoperability Forum, hosted by the Office of the National Coordinator for Health IT (ONC). These back-to-back meetings in Washington, D.C. provided a unique opportunity to ponder the past, present, and future state of interoperability.
While so many of the faces and topics were the same as in years past, there was something decidedly different about the energy and sense of optimism at both conferences. I come from the era of 2004’s Executive Order 13335, which called for a full-scale electronic update of our health system within a 10-year timeframe and created the ONC to oversee the transition. I lived through the fury of the Health Information Technology for Economic and Clinical Health Act (HITECH Act) of 2009 and the victories that came from “meaningful use” and the Electronic Health Record (EHR) certification program. Along the way, I watched the Interoperability Showcase at the annual HIMSS conference grow from a small concept, tucked far away from the rest of the exhibit floor, to a massive cornerstone of the event. Everyone wanted to show they could exchange data – but it seemed like so few really could. The presentations and discussions at last month’s conferences have made me believe that the community that has worked so hard to achieve interoperability may soon be able to realize its promises.
The 21st Century Cures Act has pulled into sharp focus what stakeholders need to accomplish to achieve interoperability. The Act calls for interoperable health IT that:
- “enables the secure exchange of electronic health information without special effort on the part of the user;
- [provides] complete access, exchange, and authorized use of electronic health information; and
- [has] no information blocking.”
This next phase of interoperability demands that systems and policies are put into place to allow patients, providers, payers, and other stakeholders to efficiently access and use the health information they need to make decisions. The widespread availability of application programming interface (API) functionality within EHR systems, the rapid development of Fast Healthcare Interoperability Resources (FHIR®) implementation guides, and the increasingly clear importance of data standards and metadata are providing the fuel needed to push the pursuit of interoperability into a new era.