ONC’s Interoperability Roadmap update

Today the Office of the National Coordinator for Health Information Technology (ONC) convenes the first joint meeting of the Health Information Technology Policy and Standards Committees. We intend to spend the day discussing interoperability in the health information ecosystem.

Committee members will hear a final report from the Joint Jason Task Force, an update from the Interoperability Governance Sub-Committee and an interim report from ONC’s Interoperability Portfolio Manager. These presentations mark several months of dedicated work developing a more detailed, shared roadmap to achieve interoperability in this nation, as a means to see that everyone has access to better quality, more affordable care and better health overall. 

These conversations follow our release, in June of 2014, of the high-level document Connecting Health and Care for the Nation: A 10-Year Vision to Achieve an Interoperable Health IT Infrastructure.  This paper describes ONC’s broad vision and framework to develop a clear pathway towards interoperability. It is intended as an invitation to health IT stakeholders – clinicians, consumers, hospitals, public health, technology developers, payers, researchers, policy makers and many others – to join ONC to develop a defined, shared roadmap that would allow us to collectively achieve health IT interoperability as a core foundational element of a learning health system.

And people responded. We have been buoyed by the active engagement by individuals, Congress and other policy makers from across the country – all interested in the same goals. We have leaned on the expertise of our partners inside and outside of the federal government, with the states, and with private sector interoperability solution entities. They all contributed valuable insights about what is already working on the ground that we can build upon to achieve short-term gains, how what we advance will allow the country to migrate the current health IT infrastructure into one that meets the opportunities of future technologies and use cases.

Perhaps this interest is because the work of the past decade has meant dramatic progress in adoption and use of health IT. We have also seen changes in payment that are creating a real business case for interoperability. And technology is evolving which will make query-based systems more accessible across the ecosystem. This digitization of the health-care experience is creating a palpable demand for the data collected to be shared so it can be put to use to improve care and improve health to advance public health and science.
As a reminder, we have been working to develop a shared roadmap to interoperability that charts a path to achieve progress in 3, 6 and 10 years. We structured our work along five critical building blocks for a nationwide interoperable health IT infrastructure: 

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

Today, we are pleased to present some of the early, strategic elements of a draft roadmap. Specifically, within these five building blocks, we are proposing key near-term actions and milestones for many of the 3, 6, and 10 year goals.

We expect Committee members will engage in a meaningful discussion and provide us with feedback as a checkpoint on this work, knowing there are three more months of work ahead before we submit a draft roadmap for public comment. We also invite you, our stakeholders and members of the public not able to join us today, to look at presentation materials on HealthIT.gov.

We have heard loudly and clearly that interoperability is a national priority, and that there is value in this effort spearheaded by ONC as the federal government’s coordinator of health IT policy. It is also apparent that there is enthusiasm, capability and a willingness to cooperate and collaborate in ways not previously seen.

We are invigorated by the collaborative energy we have seen and experienced over the few months by those who have leaned forward with us. Thank you to those who have weighed in, and we hope you will continue to stay engaged as we continue on this journey towards nationwide interoperability. 


  1. Rex Buddenberg says:

    I have researched and taught interoperability for a couple decades now. Let me make a couple comments.

    Discipline. Building large, federated information systems is a big job. And because the pieces are sourced from lots of different places, open-ended interoperability is the only way to get the mega system to work. So you have the right title.
    I have in my files an inch+half paper document titled California Statewide Communications Interoperability Plan. In all that paper, the only reference to interoperability is the cover sheet. Keep eye on the ball and don’t commit the same error. DHS has pushed the P25 comms standard for over a decade, touting interoperability. 10s of $M later, we have no interoperability. Don’t commit the same error.

    From there, things go into the weeds. The key to interoperability is modularity (it’s also the key to life cycle maintainability. Standards are the HOW of modulaility (they articulate the boundaries). But standards are not the WHAT. It’s altogether too easy to comply with all the standards and produce a mismodularized, and hence, non-interoperable, information system(s?).
    I’d suggest a means to measure interoperability. Dobn’t let this metric get clogged up with other (entirely valid, but not interoperability) requirements — make sure it measures interoperability.

  2. Laura B. HIMSS NCA Liaison says:

    Very excited to see this update announced! I forward to hearing more as things progress.

  3. Gijs van Oort PhD says:

    HASA is responsible for establishing interoperability within 22 counties in South Central texas with San Antonio as the hub, Additionally, HASA will be linked to other community HIE’s across the State via HIETExas and ultimately nationwide. HASA operates a provider portal with a link to an analytics platform and a link to a community patient portal. As a result, HASA provides value to physicians, hospitals, public health and not in the least community residents. We are very interested in actively engaging with the planning of the 10-year interoperability Roadmap, and possibly provide a “view from the trenches”.
    Thank you.

    Gijs van Oort CEO/Exec. Director

  4. New Years Eve 2016 sydney says:

    it’s too easy to comply with all the standards and produce a mismodularized, and hence, non-interoperable, information system(s?).
    I’d suggest a means to measure interoperability.

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