Nationwide Interoperability Roadmap and Standards Advisory (International Ballroom)
- Karen B. DeSalvo, M.D., M.P.H., M.S.c (@KBDeSalvoWeb Site Disclaimers)
- Erica Galvez, Interoperability and Exchange Portfolio Manager, ONC
- Christopher A. Miller, Acting Director, DoD/VA Interagency Program Office (IPO) and Program Executive Officer, DoD Healthcare Management Systems
- Steven Posnack, M.S., M.H.S., Director Office of Standards and Technology, ONC (@HealthIT_PolicyWeb Site Disclaimers)
- Lucia Savage, Esq., Chief Privacy Officer, ONC (@SavageLuciaWeb Site Disclaimers)
We can’t get there in one step. Sometimes we have to build pathways.
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:
- Core technical Standards and functions
- Certification to support adoption and optimization of Health IT product and services
- Privacy and Security protections for health information
- Supportive business, clinical, cultural and regulatory environments
- 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 www.healthit.gov) closes on Friday April 3rd, 2015.
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.
– 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.
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. cbsn.ws/1pnXnFe
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.
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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[tag health cloud, blue button, ONC2015]
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.
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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.com. 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.
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