On October 6, 2015, the Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology (ONC) released the final Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap – Version 1.0 (Roadmap) [PDF - 3.5 MB].
The Roadmap coordinates public- and private-sector efforts to advance the safe and secure exchange of electronic health information across the country to improve individual, community and population health. It defines a path forward to improve our health care system through the use of interoperable health information technology, including a focus on person-centered and self-managed care and the overall improvement of health care outcomes.
The following are public- and private-sector statements of support for advancing an interoperable learning health system:
“America’s hospitals strongly support the creation of an efficient and effective infrastructure for health information exchange that supports the delivery of high-quality, patient-centered care across health care settings. Our members are actively engaged in building their IT systems and view information exchange as vital to patient care and engagement, as well as to successful implementation of new models of care.
“We appreciate the Administration’s recognition of health information exchange as a cornerstone of the health care system of the future, as outlined in the final interoperability roadmap. Progress will take combined efforts from all stakeholders, including vendors and providers. We look forward to working with the Department of Health and Human Services (HHS) to create a policy environment that supports these efforts and accelerates the transition to the health care system of the future.
“Given the hospital field’s recent large investments in deploying IT systems, we urge HHS to focus first and foremost on efficient ways to share the data currently being collected to build a foundation for the future,” said Rick Pollack, President and CEO, American Hospital Association.
“We look forward to future and ongoing collaboration with ONC and others, including consumers, in seeking solutions that will work across the healthcare ecosystem, ultimately increasing quality and outcomes, removing access barriers and lowering costs! Nothing is more essential to providing safe, quality patient care than the ability to select the correct patient in each and every encounter, ensure that data is available in formats that are standardized for understanding and consumption and in secure, lawful circumstances,” said Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE, FAHIMA, Chief Executive Officer, AHIMA.
Allscripts is all about making data exchange a reality, having served as a model for OPEN interoperability in the development of a connected community of health since 2007, and we support the broad concepts that we understand are included in the interoperability roadmap. If the broader healthcare industry adopts these goals as our own and partners to increase consumer access to and control of their information, electronic care coordination and the adoption of standardized approaches to exchange, we will be in a measurably improved position in only a few years' time, all for the betterment of patients.
“America’s Essential Hospitals shared the Administration’s goal of giving consumers and providers secure, effective, and efficient access to electronic health information to improve care and health care outcomes.
“The Administration’s Interoperability Roadmap moves us closer to the promise of the electronic health record (EHR). We agree with its three core commitments and will review the draft standards closely.
“Essential hospitals care for low-income and other vulnerable patients, who often face social and economic roadblocks to health care access and information: poverty, homelessness, language barriers, Insert Fact Sheet Title, (Date Optional) and low health literacy, for example. It will be important to consider the needs and challenges to their care as we work toward an EHR that improves health care for all people.
“We look forward to working with policymakers as they engage hospitals and other stakeholders in the process to create standards for interoperable electronic health records,” said Bruce Siegel, MD, MPH, President and CEO, America’s Essential Hospitals.
"athenahealth has long been and continues to be committed to building an open health IT platform where patients' health information follows them throughout the continuum of care, accessible in a usable format to them and their care providers, regardless of where the information originated. Industry achievement of this goal requires a shift in focus away from the theoretical ability to exchange information and toward actual information fluidity. We support ONC’s efforts to shift its focus towards outcomes over means and to shine a light on the information blocking behaviors that prevent this the actual exchange of health information,” said Stephanie Zaremba, Sr. Manager, Government and Regulatory Affairs, athenahealth.
"Interoperability plays a necessary and important role in supporting patient-centered care and better outcomes in health care. It is also plays a critical role in advancing medical innovation in the United States," said Janet Marchibroda, director of the Health Innovation Initiative and executive director of the CEO Council on Health and Innovation at the Bipartisan Policy Center. "We applaud the leadership of the National Coordinator for Health IT and ONC in releasing the interoperability roadmap and look forward to continuing to advance efforts focused on accelerating electronic information sharing to support high quality, cost effective, patient-centered care."
“On behalf of Cerner, I congratulate Dr. DeSalvo and her team for their continued work toward meaningful interoperability. This work is foundational to support a state of data liquidity that must exist for timely diagnosis and treatment to occur and emphasizes what we believe is a self-evident ethical understanding that a person’s health data belongs to the person. We proudly pledge to continue our leadership in support of these commitments and actions outlined in the ONC Interoperability Roadmap,” said Neal Patterson, Chairman, CEO, and Co-founder, Cerner.
"We applaud ONC for highlighting the existing federal barriers to creating anational patient identification solution. We also appreciate ONC’s recognition of ongoing efforts in the private sector, such as CHIME’s National Patient ID Challenge, to solve such an important element of the critical infrastructure necessary to exchange of patient information. Providers must be able to confidently and consistently link patients with their health data before our healthcare delivery system will truly be interoperable,” said Charles Christian, FCHIME, LCHIME, CHCIO, chair of the CHIME Board of Trustees, CHIME. “ONC’s dedication to improving the status of interoperability is to be commended. CHIME and the nation’s CIOs look forward to continuing to work with ONC to foster a standards-driven, interoperable healthcare delivery system."
“CommonWell Health Alliance would like to express its support for ONC's Shared Nationwide Interoperability Roadmap as well as the three federal commitments that move the industry to a more open and connected community of health. We think it is high time that consumers were made first-class citizens in health data exchange, and that providers should have and use built-in capabilities to share individual health information for care. We aim to both implement and contribute to the applicable standards, policies and best practices for health data exchange nationally, both within and outside our open industry alliance,” said Jitin Asnaani, Executive Director.
“If we want to provide quality care at a low cost, people must be able to easily and securely access their health information” said Jennifer Covich Bordenick, CEO, eHealth Initiative. “While interoperability is not something that can be solved quickly, we have seen significant progress in the last couple years. It is encouraging to see that HHS incorporated industry feedback that was provided to them. Success will require continued collaboration from the public and private sectors. We applaud HHS for its leadership and willingness to work with providers and patients to improve upon this document. eHealth Initiative’s 2020 Roadmap complements the HHS work. We look forward to continuing our partnership with them."
“We congratulate ONC on completing this important document. The EHRA supports the high-level goals established by the Roadmap, as well as the four critical pathways set out for stakeholders. We also appreciate the Roadmap's detailed assessment of substantial interoperability progress to date.
“The ONC Interoperability Roadmap introduces concepts and structures that will be helpful in moving the healthcare industry forward to achieve broad interoperability. The EHRA appreciates the Roadmap focus on interoperability drivers, policy and technical components, and outcomes. In particular, we appreciate the objective to provide improved technical standards and implementation guidance. We strongly support the Roadmap’s call for a rapid shift and alignment of federal, state, and commercial payment policies from fee-for-service to value-based models to provide a strong business case for interoperability. And we also appreciate the inclusion of clarification and alignment of federal and state privacy and security requirements that will enable interoperability.
“The Roadmap, in calling for the use of consistent policies and business practices to support interoperability, notes that coordination with stakeholders is required, and we look forward to participating in that and other efforts to refine and implement this plan,” said Leigh Burchell, Chair, Electronic Health Record Association.
As one of the earliest facilitators of nationwide interoperability, we have a longstanding goal that wherever the patient goes - between healthcare systems in the same town or across state and national borders - the patient, her family, and the clinicians providing her care have access to the information they need. We affirm our ongoing commitment to:
- Empower patients and their families to see, understand, contribute to, save, and widely share their information through MyChart, our patient portal.
- Encourage and accelerate the progress of widespread interoperability of healthcare organizations that use our EHR with any standards-compliant destination, regardless of technology provider. We have not and will not engage in information blocking.
- Contribute to, implement, and champion both federally recognized and emerging interoperability standards.
With 35.5M patients engaged through MyChart and a rate of 220M standards-compliant patient record exchanges per year, we believe that the achievement and experience of our organizations can make a meaningful and lasting contribution to advance the state of the industry. We commit to sharing their lessons learned and best practices widely for the success of the healthcare delivery system as a whole.
“The Roadmap points the way to the interoperable health platform that consumers, clinicians, and providers can use, and can trust, to deliver seamless access to personal medical information. Interoperability is the missing link that connects the Triple Aim’s three goals we all strive for: improving the individual experience of care, improving the health of populations, and reducing costs,” said Chip Kahn, President and Chief Executive Officer, Federation of American Hospitals.
Greenway Health supports the concept of a learning health system as envisioned by the ONC Interoperability Roadmap. As we noted in our comment letter, ‘We share ONC’s enthusiasm for a multi-layered system and your understanding of it as an approach combining the robust goals of integrating interoperability, clinical research, sophisticated analytics, quality metrics and patient participation into workflows across the care continuum.'
“Through our participation and leadership within multiple data liquidity initiatives, we know there is a place for public-private collaboration, and we know that data exchange technology alone is not the answer. To truly connect our nation, we need to maintain the willpower to sit at the table together and the ability to listen to the needs of the healthcare consumer. The roadmap reflects these missions,” said Greenway Health CEO Tee Green.
“Health IT Now supports ONC’s ongoing efforts to address the systematic lack of interoperability in our healthcare system. The final Roadmap reflects input, serious thought and consideration from many stakeholders, and addresses issues of concern to our members, including information blocking and patient access to health information.
“We are particularly encouraged that ONC is seeking commitments to promote interoperability. Specifically, we support consumers having easy and secure access to their own electronic health information, an ability to direct it to any desired location and to learn how their information can be shared and used, and to be assured that this information will be effectively and safely used to benefit their health and that of their community. We believe consumers should have access to all of their own health information and that their information should be available from the most convenient source.
“We urge ONC to continue to work aggressively to meet the statutory mandate contained in the Medicare Access and CHIP Reauthorization Act of 2015 to achieve widespread exchange of health information through interoperable certified EHR technology nationwide by December 31, 2018. ONC’s actions over the next few months will help determine whether the Roadmap is a successful guide to meeting the law’s mandate,” said Joel White, Executive Director, Health IT Now Coalition.
"HIMSS reaffirms its commitment to improving the quality, safety, access, and cost effectiveness of healthcare by achieving widespread secure, electronic exchange of health information. We appreciate that ONC's Shared Nationwide Interoperability Roadmap puts us on the path to a Learning Health System--where standardized, electronic health information is securely available when needed for patients and providers to engage and drive actionable outcomes," said Carla Smith, MA, FHIMSS, CNM, Executive Vice President, HIMSS North America. "HIMSS supports the four critical pathways identified in the Roadmap that focus on using consensus-based standards, supporting the shift in payment policies from fee-for-service to value-based models, and aligning federal and state privacy and security requirements that enable interoperability. And, we support ONC's commitments that accompany the Roadmap. To ensure the right person has the right information about the right patient at the right time, HIMSS's leadership in interoperability testing, IT certification, and patient data matching remains strong," said Carla Smith, MA, FHIMSS, CNM, Executive Vice President, HIMSS North America.
“McKesson commends ONC for the release of the Interoperability Roadmap. Specifically, we applaud ONC’s emphasis on person-centered interoperability, meaning that all relevant health information is available electronically to patients, providers and care team members, regardless of setting of care, geographic location, or technology. ‘Simply put, patients have a fundamental right to access their health information and to empower their healthcare providers to do the same. ‘These rights should not be infringed by technical, financial or competitive barriers. The result will be better coordinated care and clinical outcomes for patients.
“We encourage ONC to continue to promote transparency, provide guidance and benchmarks, and facilitate dialogue among existing exchange networks. ‘By prioritizing the alignment of federal incentives and operations, the federal government can aggressively promote interoperability without hindering private sector efforts to promote innovation,” said Arien Malec, VP Data Platform, McKesson Corporation.
As an industry leading enterprise EHR, MEDITECH is committed to joining ONC In adopting the technologies and policies set forth in the Shared Nationwide Interoperability Roadmap. The vision outlined in the Roadmap aligns perfectly with our shared end goal of healthcare technology solutions, which is to provide patients and providers secure and meaningful access to healthcare information pertinent to longitudinal care. Together with ONC and other stakeholders, the MEDITECH community is poised to deliver forward thinking milestones necessary to achieve nationwide interoperability.
You have MEDITECH’s pledge to support the Shared Nationwide Interoperability Roadmap principles, including:
- Helping consumers easily and securely access their electronic health information, direct it to any desired location, learn how their information can be shared and used, and be assured that this information will be effectively and safely used to benefit their health and that of their community.
- Helping providers share individual’s health information for care with other providers and their patients as much as permitted by law and refrain from blocking electronic health information (defined as knowingly and unreasonably interfering with information sharing).
- Implementing federally recognized national interoperability standards, polices, guidance, and practices for electronic health information and adopt Best Practices, including those related to privacy and security.
Through our history of providing low-cost, certified solutions to providers and patients, MEDITECH has been focused on developing healthcare solutions that are easy to navigate, secure, and adherent to standards and Best Practices set forth by federal guiding agencies. MEDITECH is fully committed to supporting the Shared Nationwide Interoperability Roadmap.
Interoperable exchange of health data is critical to delivering high-quality, coordinated care to patients. Alignment of federal and state privacy and security requirements is essential to enabling interoperable systems that protect patient privacy and autonomy while also assisting providers in more effectively treating patients and reducing overall costs. NGA looks forward to working with ONC and states on advancing shared interoperability goals.
“We know that achieving the Triple Aim of better care, better health and lower costs relies on a learning health system in which all individuals, their families and their care providers can send, receive, find and use electronic health information,” said Debra L. Ness, president of the National Partnership for Women & Families. “The Interoperability Roadmap prioritizes treating patients and families as equal partners in creating and effectively using that learning health system. We commend ONC for leading this nationwide commitment and look forward to supporting the Roadmap implementation as we work collectively toward a health care system that better meets the needs of patients and families.”
“Members of the Premier alliance believe today’s announcement represents a significant leap forward in the national effort driving toward interoperability. We strongly believe that this roadmap will provide important guidance that will help improve consumer access to health data and the sharing of electronic health information among providers. We also support the roadmap’s recommendations for broader, governmental action to promote consistent, national interoperability standards, including the use of open source application programming interfaces (APIs) to support the secure transfer of information between and among different HIT platforms. We look forward to working with the administration to advance the technical standards, certification requirements, privacy/security standards and other initiatives that will enable true HIT interoperability,” said Blair Childs, senior vice president of public affairs, Premier, Inc.
The Sequoia Project supports the core principles in the ONC Interoperability Road Map, including the collaborative spirit, the focus on leveraging existing health IT investments, and the important coordination role that ONC can play. We look forward to working with ONC to help implement this vision,” said Mariann Yeager, CEO, The Sequoia Project.
“The ONC Roadmap is a realistic approach to ensure that our significant health care information technology investments achieve their promised aims of improving care delivery, promoting cost-saving efficiencies, advancing the public health, supporting research, and enabling future generations to benefit from more personalized approaches to disease prevention and treatment. Guided by a collective vision of making health care information available wherever it is required, the Roadmap describes how we can best align payment structures, policies, and technologies to foster innovative approaches to address the many challenges encountered in today's fragmented health care system. Although the Roadmap is of necessity drafted in technical terms, it's true purpose is clear - the pursuit of innovations promising to relieve patients, families, and providers of many burdens they face every day in their pursuit of health,” said Mark Frisse, MD, MS, MBA, Accenture Professor of Biomedical Informatics in the School of Medicine, Vanderbilt University.
“We have made important progress in making health records available to patients and shareable among their doctors,” said HHS Secretary Sylvia M. Burwell. “Today, we are taking another important step forward by releasing a comprehensive strategy to engage government partners and the private sector to develop a network where health information can be safely and securely accessed from different sources. This shift will put patients at the center of their health care, improve the quality of the services they receive and advance safety overall.”
“For the past two years, the Department of Defense and Office of the National Coordinator for Health Information Technology have worked collaboratively to modernize our military’s Electronic Health Record. A key component of this effort is seamless integration of care and health data across the U.S. Department of Defense (DoD), Department of Veterans Affairs, and the private sector. This information exchange is vital to improving the overall readiness for our military, while ensuring Service members and beneficiaries receive the quality care they deserve, whether in garrison or theater. The DoD is committed to interoperability and ONC’s Roadmap will ensure that our efforts align with nationally-recognized data standards, industry best practices, and continuity of care as our Service members transition to Veteran status,” said Chris Miller, Program Executive Officer for the DoD Healthcare Management Systems Modernization and Integrated Electronic Health Records program.”
“Veterans live and work in every health care delivery market in this country. Approximately six out of 10 Veterans receive some portion of their health care from private sector providers. As such, Veterans represent one of the nation's strongest business cases for interoperability. The Office of the National Coordinator for Health Information Technology (ONC) Interoperability Roadmap represents a multi-stakeholder effort to converge on foundational goals and strategies to achieve interoperability. The U.S. Department of Veterans Affairs (VA) is fully supportive of this national approach to address policies, foster technological advancement and expand health information exchange. The roadmap framework supports VA's goal to achieve Veteran-centric care by making information available, coordinating patient goals and care plans across the continuum and using holistic data to drive care management, decision support and analytics. VA looks forward to continuing to working closely with ONC, as well as our federal and private sector partners to further health information exchange in our nation,” said VA Under-Secretary for Health Dr. David Shulkin.
“As the Interoperability Roadmap makes clear, a patient's information must follow them wherever they choose to get care and any efforts to block that from happening are unacceptable,” said Andy Slavitt, Acting Administrator, Centers for Medicare and Medicaid Services. “CMS believes that data and information are as important an ingredient as paying for value in keeping people healthy.”
“The Roadmap is a critical tool for improving the health care delivery system through the safe and secure use of health information technology,” said Jim Macrae, Acting Administrator for the Health Resources and Services Administration. “The opportunities for coordination and collaboration provided by the Roadmap will help our programs deliver better quality care for the populations they serve.”
“As part of the Precision Medicine Initiative, the National Institutes of Health (NIH) plans to build a national research cohort of 1 million or more Americans to expand our knowledge and practice of precision medicine,” said NIH Director Francis S. Collins, M.D., Ph.D. “Accurate data will both enable and define the scientific possibilities for the Precision Medicine Initiative. ONC’s interoperability Roadmap will be essential for standardizing data acquisition, technologies and policies to ensure data arising from healthcare delivery can support both discovery science and healthcare improvement.”
“The U.S. Department of Health and Human Services Office of Civil Rights (OCR) appreciates our strong partnership with the Office of the National Coordinator for Health IT (ONC) in the area of health information technology and efforts to improve nationwide health information exchange. The Interoperability Roadmap is key to achieving seamless, secure exchange of information for purposes of treatment, care coordination, public health and other important purposes. The Health Insurance Portability and Accountability Act (HIPAA) has always recognized the importance of sharing information for these purposes, and thus has always permitted secure exchange for these reasons pursuant to the Privacy Rule. We look forward to continuing to work with ONC to issue guidance to address any lingering questions about the application of HIPAA to common exchange scenarios,” said Jocelyn Samuels, Director, Office of Civil Rights, U.S. Department of Health and Human Services.
“Health plans contracted with the U.S. Office of Personnel Management’s (OPM’s) Federal Employees Health Benefits (FEHB) program cover health services for more than 8.2 million Federal employees, retirees and their family members in every county in the country and overseas. The exchange of health data through safe and secure channels using common standards and protocols will lead to better care for our enrollees and a more efficient health system overall. OPM appreciates the leadership of the HHS Office of the National Coordinator on this issue and commits to working with our 97 contracted health insurance carriers to incorporate these standards and data sharing protocol in their information systems, said Jonathan Foley, Director, Planning and Policy Analysis, U.S. Office of Personnel Management.”
For more information on the Roadmap or other ONC’s programs, please visit www.healthit.gov.
Download the Statements of Support [PDF - 410 KB]