On June 5th 2014, ONC released “Connecting Health and Care for the Nation: a 10-Year Vision to Achieve an Interoperable Health IT Infrastructure

The plan is divided in 3 year goals, 6 year goals, and 10 year goals. Five specific tactics support the strategies.

Below is a summary of the report and a few comments from my Massachusetts experience that support the reasonableness of the ONC goals. Based on the trajectory of current technology and policy, I’m confident we can achieve these milestones. One caveat – since Meaningful Use Stage 3 takes effect in 2017, three years from now, we will need to adjust the scope and focus of Stage 3 to align with the ONC three year goals. I’ve written in previous posts that we should simplify future stages of Meaningful Use to less than 10 policy goals, highlighting interoperability, without being overly prescriptive. The ONC Vision gives us the opportunity to do that.

Three-Year Agenda: Send, Receive, Find, and Use Health Information to Improve Health Care Quality

1. Ensure that individuals and care providers can send, receive, find, and use a basic set of essential health information. This requires the ability to appropriately search for and retrieve health information, in addition to point-to-point information sharing.

Massachusetts has already built statewide Direct gateways for transport of payloads from one location to another. The Commonwealth is also live with a master citizen index, relationship locator service, consent repository, and the necessary web services/standards to support query/retrieve workflows. We stand ready to share 100% of our implementation guides with the HIT Standards Committee and ONC. I know that the send, receive, find, and use goal is achievable in three years, because Massachusetts is in production with the functionality today.

2. Address critical issues such as data provenance, data quality/reliability, and patient matching.

As with the first goal, the state government of Massachusetts has already implemented statewide patient data matching and a team to support demographic data cleanup. BIDMC has worked with the Massachusetts eHealth collaborative to build a community-wide Quality Data Center that successful merges CCDAs from the state HIE, taking into account data provenance, patient matching and data quality issues. We’ve experienced the operational realities of maintaining a public utility for patient identity management and data normalization, so we know it is possible to achieve at scale.

3. Enhance trust by addressing key privacy, security, and business policy and practice challenges to advance secure, authorized health information exchange across existing networks.

Massachusetts has established a set of HISP to HISP connections using a combination of whitelists and blacklists. Our approach has become simpler over time, shaped by the experience of day to day operations. I am confident that a trust fabric of federated networks is possible without overcomplicating the technology and policy.

Six-Year Agenda: Use Information to Improve Health Care Quality and Lower Cost

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