With the passage of the 21st Century Cures Act, interoperability in healthcare IT is legally supposed to be achieved by the end of the year. It is a more urgent concern now than never before not only because of the legal implications imposed but also because of the goals set out in The Interoperability Standards Advisory for 2017 by the Office of the National Coordinator (ONCHIT).
The standards seek to facilitate interoperability by establishing implementation specifications and essential standards that are determined in collaboration with the majority of the healthcare IT vendors and other private and public sector partners.
Some of the important elements include:
No blocking of information
Use of standardized APIs
Facilitating patients’ data access.
To support the sharing of health information by patients, S4S will have to use standards and specifications that are applicable to all the various EHR vendors. In support of the ongoing interoperability efforts, the S4S will be set up on the already existing open specifications and standards (SMART Health IT, FHIR, CMS EHR Incentive Program, Argonaut). The adoption of the industry-wide open, standardized APIs aligns with the objectives of ONC of connecting and accelerating an FHIR ecosystem.
The S4S is meant to use a SMART Health IT and REST API OAuth profiles for security and the HL7’S FHIR specifications for data models. The Common Clinical Data Set will spell out the vocabularies and the scope of data access to be used. Most of the providers and vendors participating in the S4S are also taking part in the Argonaut project. The Argonaut project supports the adoption of the same open specifications across the industry. The vendors taking part in the S4S will, therefore, be able to leverage on the achievements of the Argonaut project.
To provide high-quality care, it is crucial for medical professionals to have the complete picture of a given patient’s health record. This was not the case in the past, as the records that are outside one’s own four walls were not always readily accessible and would require effort in retrieving. The information that was readily accessible was only confined to one’s own institution (doctor’s office or hospital).
Sharing of information is still a critical piece in improving the general health care sector. While infrastructure is still needed to organize and capture data, it is of paramount importance that community leaders, individual and health care professionals gain access and share data, and then exploiting it to make better decisions. It is estimated that more than 200,000 Americans die each year on account of medical errors alone. IT has a great role to play in reducing this number and enabling advancement in the health sector.
IT can further contribute to the health sector decision making processes by availing relevant data to the medical professionals that would otherwise have not been available. The truth of the matter is that some of the most important health details of a person may not be found within a doctor’s office. Actually, health care may only contribute a small portion of the total sum of the health of an individual. To get the complete picture of a person’s health status, more information might be needed than is to be found in the electronic health record. It is for this reason that the JASON group has been tasked by the U.S. Department of Health and Human Services (HHS) to find a way of establishing a health information system that emphasizes on the health status of people and not just the health care that they get.
It is important to pursue this objective as in the current information age; there is an explosion of data from all walks of life that can help improve decisions in health. Data from patient collaborative networks, genomic data, from personal health devices, social media, and demographic/ environmental data may all be useful in one way or another. It is important to come up with an infrastructure that can capture, share and integrate all these diverse data elements while maintaining interoperability among the different EHRs.