Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

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AHA: ONC Health IT Standards Guidance Lacking Specificity

AHA has made four recommendations for improving the federal government's guidance on health IT standards to improve healthcare interoperability.

- On Tuesday, the American Hospital Association (AHA) issued comments on the 2017 Draft Interoperability Standards Advisory calling on the Office of the National Coordinator for Health Information Technology (ONC) to get more specific about the state of current and emerging health IT standards and the means of using them in clinical care settings.

AHA on health IT standards in ONC advisory

In total, the organization has recommended four actions for the federal agency to take to help providers assess the readiness of health IT standards and specifications for implementing them.

First, AHA seeks "greater detail about the characteristics and metrics used to distinguish between standards that are considered mature and those that are characterized as emerging" from ONC via the most recent Interoperability Standards Advisory.

According to association, doing so will require the federal agency to reach out to the standards community.

"The AHA urges ONC to prioritize outreach to organizations conducting maturity assessments so that future iterations of the ISA can include this reference," writes Ashley Thompson, Senior Vice President for Public Policy Analysis & Development. "In addition, the AHA recommends that ONC use the ISA to make publicly available the feedback it receives on the adoption experience of standards and implementation specifications."

Second, ONC needs to inform providers about the readiness of health IT standards for live performance:

The AHA recommends that the 2017 ISA also include information on actual standards use in the real world, and not just adoption. The Draft 2017 ISA uses the term “adoption level” to indicate whether a standard has been adopted in health care and a graphic to indicate the level of adoption, from low to high, for a particular standard. However, experience to date indicates that a standard may have a high adoption rate as a result of a health information technology (IT) certification requirement, although it does not meet provider needs.

Third and more specific to healthcare interoperability, AHA recommends that ONC share information about the impact of health IT standards on supporting healthcare interoperability in highlighting the achievements of private-sector initiatives in promoting their use.

"Support for standards implementation through the development of educational materials, funding for technical assistance, national provider calls and ongoing support will be crucial to the successful adoption of standards and implementation specifications that are updated regularly and federally required," Thompson argues.

Lastly, ONC must get more specific about health IT standards and implementation specifications by providing convenient access to online resources, especially those pertaining to federal programs. "We agree with the use of hyperlinks to direct stakeholders to additional detail on the standard or implementation specification. Including access to information on pilot projects would further inform stakeholders about how standards perform," Thompson advises.

Additionally, AHA is directing ONC to maintain static records alongside its move to make the ISA a web-based resource:

The AHA also recommends that ONC continue to make a static PDF of the ISA available as well as develop an appendix to capture the resources that are linked to the respective characteristic that accompanies each standard or implementation specification. The web-based resource and the PDF support distinct needs by stakeholders, and we urge ONC to maintain both options to access this resource.

ONC issued the 2017 Draft Interoperability Standards Advisory in late August. Key features of the latest advisory include the discontinued use of "best available" to describe any health IT standard and limiting its scope to the interoperability of clinical health IT systems and not the interoperability of administrative or payment-oriented technology.

This year's draft bears much of the feedback of the 2017 Interoperability Standards Advisory Task Force delivered to the Health IT Policy and Standards Committees in July, the most important of which was a clear focus on getting certified EHR technology and health IT systems to eliminate information gaps in healthcare.

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