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ONC Teases Retooling of Nationwide Interoperability Roadmap

ONC stuck to the interoperability roadmap for six years, but it is time to advance to the next level of health IT.

After six years of following the Office of the National Coordinator for Health IT (ONC) nationwide interoperability roadmap, the agency said it is now time to execute on its goals, according to a recent ONC blog post.

“At a time when consistent direction was needed, the Roadmap sparked action and sharpened dialog across a number of technology and policy dimensions,” wrote Steve Posnack, MS, deputy national coordinator for Health IT, acknowledging that the Roadmap laid a good foundation.

“Collectively, we have all made solid progress on many of the early milestones identified by the Roadmap,” Posnack added. “It’s important to recognize those successes while at the same time acknowledging that the Roadmap itself no longer drives our work. Though the Roadmap has been sunset slightly ahead of the third time band’s final date, it will continue to be accessible on for referential purposes.”

With the 21st Century Cures Act and some regulations in place, along with the 2020-2025 Federal Health IT Strategic Plan, Posnack said the future of health IT interoperability is in an area to steer away from the Roadmap.

“Indeed, from ONC’s perspective, we will continue to lean into our coordination role across government and industry; align investments in standards development, pilots, and programs; promote the implementation and use of what’s been built over these many years; and drive to outcomes not yet fully realized,” Posnack said. 

None of that is to say the Roadmap did not serve its place in advancing health IT interoperability forward.

“Indeed, having worked on the Roadmap, it’s hard to believe that we’re almost midway through 2021,” Posnack wrote. “Like many of you, I’ve got my wish-we-could-haves, but on the whole the entire health IT ecosystem has made substantial leaps forward in many areas highlighted by the Roadmap.”

Since October 2015, the Roadmap provided the direction for health IT policy development on electronic nationwide health information exchange, information blocking, and clinician burnout, Posnack added.

ONC leaders developed EHR usability tools, implemented usability regulations, and increased health IT discussion throughout the last decade. Some efforts are also moving to address the EHR usability problem.

ONC created the Strategic Health IT Advanced Research Project (SHARP) program to focus on the key issues that interfered with health IT adoption. The agency also constructed a project to address barriers to health IT use through patient-centered cognitive support.

HHS and ONC linked clinician burnout and patient safety when it established a set of safety-enhanced design certification requirements for EHR usability.

Also following the Roadmap, ONC produced the Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs. It fulfilled a provision in the 21st Century Cures Act, requiring HHS, ONC, and CMS to produce a summary for Congress on the strategies and recommendations to aid the epidemic.

“On the technical side, the Roadmap set the stage for regulatory and industry investment around the HL7® Fast Healthcare Interoperability Resources (FHIR) standard and application programming interfaces, spoke to the need for what is now the United States Core Data for Interoperability (USCDI) standard, and laid out a vision for patients and their care teams to have greater, more convenient access to electronic health information,” Posnack explained.

The agency adopted the first version of USCDI as a standard in the ONC Final Rule, which set a foundation for increased patient data sharing to boost patient care.

In January 2021, ONC released USCDI Version 2 to enhance interoperability and patient data exchange between patients, providers, and other users.

ONC originally outlined the Roadmap over a ten-year timeline, from 2015 to 2024. Every three-to-four year “band” has a long-term plan, outline, and strategy. Although the blog post did not divulge details, Posnack suggested it is time to realign health IT and data interoperability goals to meet the industry where it is at.

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