Interoperability has long seemed like a mythical, uncatchable dragon. But, thanks to parallel efforts to get disparate health information technology systems to speak with one another and exchange information, this elusive, yet essential, component of health care reform might finally become a reality.
The Office of the National Coordinator for Health Information Technology is spearheading the push nationally, and unveiled a draft version of a 10-year road map to reach interoperability, with milestones in three and six years. Despite the recent departure of ONC head Karen DeSalvo, industry experts expect the office to maintain its support of the road map.
ONC hopes that the final document will describe the detailed path toward the future state of health care and pinpoint what actions must be taken by whom to get there, says Erica Galvez, interoperability portfolio manager. If all goes smoothly, there should be a version released for public comment in January, with a final version out in March. Galvez stresses that this will be an ongoing process over the coming years, with the document constantly shifting. She believes 10 years is a realistic and reachable endpoint.
“Achieving even the three-year goal will require unprecedented collaboration across the health IT ecosystem,” Galvez says. “What we’ve described at three, six and 10 years is absolutely possible. We tried to strike a clear balance between ambition and being realistic. But that will mean the whole spectrum of health IT users will have to work together. Health care companies, she says, will have to shift mindsets, competing based on quality and value rather than “holding someone’s data hostage.”
Some, however, are concerned that a long timeline in a rapidly evolving field might mean that today’s gold standard will be obsolete quickly, says Dan Haley, vice president of government and regulatory affairs for tech provider Athena Health. He hopes that the government focuses on outcomes, rather than mechanisms, and believes that consumers are already driving change.
Getting everyone started toward interoperability is not easy. As recently as about six months ago, St. Joseph’s Hospital Health Center in Syracuse, N.Y., was exchanging records mostly via fax machine to providers. But after adopting a Surescripts clinical messaging service, it’s electronically exchanging care documents, says Charles Fennell, chief information officer. Fennell says the change is a step in the right direction, and essential for newer payer contracts. “We need to move faster as an industry, and the changes in the delivery model that are being thrust upon us are going to necessitate that we do this quicker,” he says.