Even if you’re not a standards guru, it’s not a stretch to say that standards help the world go ‘round, especially in the world of health information technology (health IT).  

ONC is excited to share the 2021 Interoperability Standards Advisory (ISA) Reference Edition. Whether you’re a policy wonk, a software developer, or a public health pro, there’s a little something for everyone this year.  (And if you are a standards professional, you might want to track the ISA’s RSS Feed – requires RSS Feed viewer – to stay on top of all changes to ISA, in real-time.)   

Many of the changes this year are iterative in nature, but a few are noteworthy.  

Top Updates to the ISA for 2021 

COVID-19 – At the top of the list is a new sub-section on the COVID-19 Novel Coronavirus Pandemic, as well as a Specialty Care and Settings “tag” for COVID-19 related interoperability needs across the ISA. These additions, updated often, are a great resource if you are looking for the latest in health IT response to the COVID-19 pandemic.   

Public Health Emergency – In addition to the COVID-19 sub-section and Specialty Care and Settings listing, we’ve added four interoperability needs connected to public health emergency response. These include sections on health care personnel status, the use of hospital/facility beds, lab operations (population lab surveillance), and population-level morbidity and mortality. Together, these elements can help emergency officials maintain situational awareness around public health emergencies and optimize emergency operations. 

Admission, Discharge, and Transfer (ADT) Notifications to a Record Locator Service – A new interoperability need has been added to support ADT notifications of patient encounters to a Record Locator Service, which is a key component of identifying patient records to support alerting use cases by health information exchanges.  

There were also numerous revisions to existing interoperability needs across the ISA. These include re-wording of some interoperability need names as well as revisions to all interoperability needs within the Administrative Standards Operating Rules sub-section to reflect changes to naming conventions of Operating Rules by CAQH CORE. Larger structural changes to the ISA can be tracked at the Recent ISA Updates page, while more granular updates to the ISA can be tracked using the RSS Feed mentioned above.  

In addition to the various changes to the ISA itself, the ONC leveraged the ISA web platform  to support expansion of the United States Core Data for Interoperability (USCDI), through the new USCDI ONDEC submission system. Remember that Draft USCDI V2 is now available for comment and Approved Standards for 2020 are listed now too pursuant to the Standards Version Advancement Process (SVAP). More information about the Draft USCDI V2 and the SVAP is available in the first edition of the ONC Standards Bulletin, a periodically published communication for healthcare stakeholders that includes updates about ONC health IT standards initiatives. Sign up to be notified about standards news. 

The ISA Supports Social Determinants of Health 

In other ISA news, a State Health Official letter issued this month by the Centers for Medicare & Medicaid Services’ Center for Medicaid & CHIP Services encouraged states to review standards within the ISA. In particular, it urged Medicaid and CHIP agencies to consider incorporating social determinants of health industry standards – particularly in the areas of food, housing, and transportation insecurity – into their programs.  

Using the ISA 

How is the ISA used? is a common question ONC receives.  References from other government agencies and programs to the standards included in the ISA are a prime example of how our stakeholders and users of health IT can leverage the ISA to ensure awareness and use of standards that support an interoperable health IT ecosystem.  Your continued engagement through the ongoing public comment process is necessary to ensure the ISA remains accurate and up to date.  

We truly appreciate the time you took to review the ISA and provide comments and look forward to any additional feedback. Should you identify other possible improvements, feel free to let us know as we continue to update the ISA throughout the year.