A task force is preparing recommendations for the Office of the National Coordinator for Health IT suggesting that in order to place a greater emphasis on interoperability, the scope of meaningful use Stage 3 should be significantly narrowed.
The ONC JASON Task Force is a response to a white paper written by the JASON initiative within the McLean, Va.-based Mitre Corp., and funded by the Agency for Healthcare Research and Quality. That paper concluded that the lack of interoperability among the data resources for electronic health records (EHRs) is a major obstacle to the effective exchange of health information. The paper recommended that CMS use Stage 3 meaningful use to embark upon the creation of a truly interoperable health data infrastructure.
During an Oct. 1, 2014, meeting, task force members expressed support for the notion that ONC should reduce the breadth of meaningful use requirements to focus on use cases demanding interoperability in order to free up provider and vendor resources to implement and adopt public application programming interfaces (APIs).
The task force also plans to recommend that ONC develop a public-private vision and roadmap for a nationwide coordinated architecture for health IT. “This coordination should target enabling and encouraging HIT market forces towards developing Data Sharing Networks that can leverage a new Public API that exposes Core Data Services and Core Data Profiles,” the draft report states.
According to the draft report, this coordinated architecture should be based on the use of a public API that can enable data- and document-level access to EHR-based information in accordance with modern interoperability design principles and patterns. They recommend that the first uses of the public API should support data-sharing networks that promote EHR-to-EHR interchange, and consumer access to the core data services via patient portals.
The task force stated that it believes that FHIR (Fast Healthcare Interoperability Resources) and FHIR profiles are currently the best candidate API approach to data-level and document-level access to healthcare data.
The task force also notes that federal advisory committees such as the HIT Policy Committee and the HIT Standards Committee are not structured to perform operational activities. “Thus, based on these recommendations, ONC should contract with a standards development organization or well-accepted, operationally active industry consortium to establish and maintain the specifications of the Public API, Core Data Services, and Core Profiles, define staging of the expansion of the Core, and deploy monitoring and compliance structures and processes.”
After some further refining, the task force will make its recommendations to the HIT Policy Committee and Standards Committee later in October.
