Monday, February 02, 2015

#ONC2015 Interoperability Roadmap and Standards Moderated by @KBDeSalvo

Nationwide Interoperability Roadmap and Standards Advisory (International Ballroom)

Karen DeSalvo

We can’t get there in one step. Sometimes we have to build pathways.

Erica Galvez

People need access ot the right information at the right time in a format they can use.

The Average Medicare Beneficiary sees 2 Primary Care Providers and 5 specialists in a year.
Only 10-20% of health outcomes are attributable to health care.

Beneficiaries should be able to send, receive and view health care information.

Five core building blocks:

  1. Core technical Standards and functions
  2. Certification to support adoption and optimization of Health IT product and services
  3. Privacy and Security protections for health information
  4. Supportive business, clinical, cultural and regulatory environments
  5. Rules of engagement and governance.

Restful APIs get another shout out for scalable delivery of information. Certification also includes testing tools.

Tracking progress includes measuring the capability of both consumers and providers to securely exchange data.

The public comment period on the Interoperability Roadmap (on closes on Friday April 3rd, 2015.

Lucia Savage

Roadmap definition of Interoperability:

“Ability of a system to exchange information wth and use information from, other systems, without special effort on behalf of the customer.”

Representation of Permission to Collect Information is a patchwork across states. This makes it hard to work at a nationwide level.

Patient Choice Strategy: Move from Consent Management to “Computable Privacy”.

Computable Privacy starts with Permitted Uses. These are background rules that support information exchange.
People have a basic choice. They may then have granular choices.

Steve Posnack Interoperability Standards Advisory

What is the purpose of Interoperability. GET SPECIFIC!

Different combinations of standards may be needed to achieve objectives.

Provide a single point for standards discussion.
Promote discussion and comment on standards

Don’t be a bystander in the Standards Discussion

ISA – Is a non-regulatory document. All hands on deck experience.

How will this be used?
The vision is that it will be a widely vetted resource developed in one place. Put the work in early to gain common momentum.

Four Sections:
– Vocabulary
– Syntax
– Content Standards
– Transport Standards

These work together in tandem and cumulatively.

This will be an annual publication that culminates from an ongoing series of publication and review and comment.

Christopher Miller

More than half of care in the DoD/VA is carried out by Private Organizations.
Delivery of care is very similar but the situation for the delivery of care may be very different.

Giving a fascinating insight in to the delivery of car in a war situation. Saving lives where previously soldiers would have died.

At the beginning of the war patients were given printed copies of medical records.

Lt Cpl Kyle Carpenter threw himself on a grnade to save his comrades. He died three times before he received his first care. Now after 40 surgeries he is able to run marathons and skydive.

DoD and VA share 8.4M Patient records. 3.2M records accessed daily.
1.5M data elements exchanged every day

Implemented a Legacy Viewer that allowed both systems to be viewed. Browser access to 25 data domains and 5.9M Patients. Data is pulled in real time. Working on integrating Private Sector data too.

How can industry help us serve our members and veterans better?
– Interoperability and data sharing is critical. We need the same level of sharing with the private sector.

Questions and Answers


The CCDA is not the greatest or complete format. However, it is something that can be iterated upon to improve.

Patient Identification

Language in recent legislation gives more flexibility. ONC have some initiatives with HIMSS in the arena of patient matching.

Aligning policies with HIPAA.

Basic choice is more than opt-in/opt-out. This is an attempt to capture information that is already manfiest. In other words people have consented or prohibited the sharing of their information.

Granular Choice: reflects the variations in state-based legislation.

Can the VA/DoD give insight on what they are looking for in their next EMR

DoD/VA is working with ONC to communicate better in this area.

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Mark Scrimshire
Health & Cloud Technology Consultant

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Stay up-to-date: Twitter @ekivemark

I am currently HHS Entrepreneur-in-Residence working on an assignment to update BlueButton for Medicare Beneficiaries. The views expressed on this blog are my own.

I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.
Medyear: Less hassle. Better care.

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