Input on Nationwide Interoperability Roadmap, made transparent by ONC

John Rancourt and Julie Crouse | October 16, 2014

We promised that the journey for drafting the nationwide interoperability roadmap would be collaborative and transparent, and today we are posting public summaries from a number of in-person meetings we held. ONC used a variety of channels to work collaboratively with and accept feedback from stakeholders as we developed the draft roadmap we posted earlier. These included meetings with industry subject matter experts (SMEs) and state health IT leaders.

Subject Matter Experts

We met with almost 30 SMEs from within the health care industry and from other industries that have already achieved interoperability in their own non-health IT systems. The SME group provided valuable feedback on goals and milestones that must be achieved in each building block at the 3, 6 and 10 year intervals.

While there were naturally areas of disagreement among the groups, there were many areas of convergence including:

  • Achieving the 10-year vision requires coordination among entities beyond the health-care delivery system, ONC, and HHS more broadly.
  • A tension exists within the industry that hinges on improving and refining the current stack of standards, and pushing more aggressively to develop and implement new standards.
  • Financial incentives to share data are shifting significantly, and this will help to push forward universal interoperability.
  • ONC will need to carefully consider industry partnerships to identify areas where oversight and regulation are necessary, and to form guiding principles that can be used to guide the industry towards interoperability.
  • Identifying draft milestones for the 3, 6 and 10 year intervals.

State Representatives

ONC also worked with over 90 officials from 38 different states throughout the summer to ensure state input was thoroughly provided. The process culminated in an in-person meeting on August 27 attended by 18 state representatives, with 10 more joining by phone.

State participants expressed their desire for ongoing partnership with the federal government throughout the implementation of the roadmap.  In summary,

  • States see the establishment of a national approach to governance for interoperability and health information exchange and federal leadership as essential to realizing significant progress over the next few years.
  • States have significant concerns about developer behavior that limits interoperability and encourage ONC to take action against developers with business practices that create barriers to exchange.
  • States support better defined and constrained content standards to enable true semantic interoperability and actionable information at the point of care.
  • States support ensuring the roadmap is broad enough to include clinical and administrative data, and the role of payers in the roadmap.

A summary report of the meetings is available on We encourage you to review both reports.

We will continue to encourage a collaborative and transparent process, and will continue to post similar reports, as well as resources related to the roadmap and interoperability on the Interoperability Portfolio page.

Our ultimate goal is to have a nationwide, learning health system where accurate and evidence-based information helps ensure the right individual receives the right care at the right time to increase health-care quality, lower health-care costs and improve population health.

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