A Call To Action for a Nationwide Interoperable Health IT Infrastructure

Dr. Karen B. DeSalvo | June 5, 2014

Today we are pleased to release 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 for interoperability and is an invitation to health IT stakeholders – clinicians, consumers, hospitals, public health, technology developers, payers, researchers, policymakers and many others – to join ONC in developing a defined, shared roadmap that will allow us to collectively achieve health IT interoperability as a core foundational element of better care, at a lower cost and better health for all.

Over the past decade, there has been dramatic progress in adoption and use of health IT across the nation.  Through deliberate policy and programmatic action, the majority of hospitals and professionals eligible for the Medicare and Medicaid EHR Incentive Programs has adopted and are meaningfully using health IT. Across the nation, various types of health information exchange show that data can flow and be used to improve care and health.  This progress has laid a strong base upon which we can build.  There is much work to do to see that every person and their care providers can get appropriate health information in an electronic format when and how they need it to make care convenient and well-coordinated and allow for improvements in overall health. 

We have heard loudly and clearly that interoperability is a national priority.  We also see that there is a tremendous opportunity to move swiftly now.  We know that consumers increasingly demand that their data flow and follow them across care settings and beyond.  Payment and delivery system reform are driving a desire from employers, payers, and health systems to share data to reduce redundancy and waste and improve care.  Clinicians are ready for data to enable and inform care and improve their efficiency.  Innovators are stretching our imagination on ways to collect and appropriately use data to improve health.  And evolving technology is providing us with promising new ways to achieve interoperability. 

Achieving this vision will take a strategic and focused effort by the federal government in collaboration with state, tribal, and local governments and the private sector.  We will develop a shared agenda that focuses on 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

These building blocks are interdependent and progress must be incremental across all of them over the next decade to realize this vision.  We will collaboratively develop use cases and goals for three, six and ten-year timeframes that will guide work in each of the building blocks, including alignment and coordination of prioritized federal, state, tribal, local, and private sector actions.

There is no better time than now to renew our focus on an interoperable health IT infrastructure, which includes the following key characteristics:

1)     Allows individuals and care providers to securely search, retrieve, send, and receive essential, electronic health information

2)     Has a sustainable, equitable governance structure that is flexible and resilient

3)     Supports novel data sharing and analysis, including patient-generated data and data from other sources beyond the health care delivery system

4)     Reflects many of the values and concepts in the JASON report, “A Robust Health Information Technology Infrastructure”

We invite you to read Connecting Health and Care for the Nation and offer your feedback and ideas for making the vision a reality.  Over the coming months we will offer several opportunities to provide input as we shape a national interoperability roadmap and encourage participation from all.