Care Coordination and Interoperable Health IT Systems

1. Care Coordination and Interoperable Health IT Systems Unit 3: Overview of Interoperable Health IT Lecture c – National Strategy for Health Interoperability This material (Comp 22 Unit 3) was developed by Columbia University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 90WT0004. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/.

2. Overview of Interoperable Health ITLearning Objectives • Objective 1: Define health care interoperability (Lecture a) • Objective 2: Summarize the vision and benefits of interoperable health IT (Lecture a) • Objective 3: Identify and examine barriers and challenges to obtaining interoperable health IT (Lecture b) • Objective 4: Discuss the U.S. strategy for health interoperability (Lecture c)

3. ONC’s national strategy for health interoperability • Build an interoperable health IT ecosystem that supports a learning health system

4. Federal Health IT Strategic Plan • Vision • High-quality care, lower costs, healthy population, and engaged people • Mission • Improve the health and well-being of individuals and communities through the use of technology and health information that is accessible when and where it matters most 3.10 Figure (Office of the National Coordinator for Health Information Technology, 2015)

5. Interoperable health IT and the Federal Health IT Strategic Plan • Goal 1: Advance person-centered and self-managed health • Goal 2: Transform health care delivery and community health • Goal 3: Foster research, scientific knowledge, and innovation • Goal 4: Enhance the nation’s health IT infrastructure 3.11 Figure (Office of the National Coordinator for Health Information Technology, 2015)

6. Goal 4 of the Federal Health IT Strategic Plan relates to interoperable health IT 3.12 Figure (Office of the National Coordinator for Health Information Technology, 2015)

7. ONC’s “Shared Nationwide Interoperability Roadmap” • Published in October 2015 • Starts in 2015 and ends at the end of 2024 • Begins on the platform of Meaningful Use • Ends at a Learning Health System 3.13 Figure (Office of the National Coordinator for Health Information Technology, 2015)

8. Roadmap sections 3.14 Figure (Lorenzi, V., 2016)

9. Drivers • Develop a supportive payment and regulatory environment • Create a progressive shift from 2016-2024 towards more and more value-based care • For more information about value-based care, please go to component 23 (value-based care) • This will motivate providers to value interoperability

10. Policy and technical components • Shared decision-making, rules of engagement, and accountability • Ubiquitous, secure network infrastructure • Verifiable identity and authentication of all participants • Consistent representation of authorization to access electronic health information • Consistent understanding and technical representation of permission to collect, share, and use identifiable health information

11. Policy and technical components(Cont’d) • Industry-wide testing and certification infrastructure • Consistent data semantics • Consistent data formats • Standard, secure services • Consistent, secure transport technique(s) • Accurate individual data matching • Health care directories and resource location

12. Outcomes • Individuals (i.e. patients or consumers) have access to longitudinal electronic health information, can contribute to that information, and can direct it to any electronic location • Provider workflows and practices include consistent sharing

13. Roadmap journey • 2015: Meaningful Use achieved for much of the country, with 94% of eligible hospitals and 78% of eligible providers are EHR users • End of 2017: Across the nation, we will send, receive, find, and use priority data domains to improve health care quality and outcomes 3.15 Figure (Office of the National Coordinator for Health Information Technology, 2015)

14. Roadmap journey (Cont’d) • End of 2020: Expand data sources and users in the interoperable health IT ecosystem to improve health and lower costs • End of 2024: a learning health system, with the person at the center of a system that can continuously improve care, public health, and science through real-time data access 3.16 (Office of the National Coordinator for Health Information Technology, 2015)

15. Unit 3: Overview of Interoperable Health IT, Summary – Lecture c, National Strategy for Health Interoperability • ONC’s national strategy is to build an interoperable health IT ecosystem that supports a learning health system • ONC developed a federal health IT strategic plan that includes a goal to enhance the nation’s health IT infrastructure • ONC published the “Shared Nationwide Interoperability Roadmap” in October 2015

16. Unit 3 Summary: Overview of Interoperable Health IT • The national vision of interoperable health IT is to build an interoperable health IT ecosystem that supports a learning health system • There are many benefits from interoperability, including: having information available to support improved care and to improve population and public health, engaging patients and caregivers, and having more efficient and value-added care • The challenges to interoperable health are: 1) not enough standardization; 2) not fully used standards; 3) patient matching; 4) privacy and security; 5) incentive alignment; 6) provider workflow; 7) larger eco-system; and 8) costs • There is a federal health IT strategic plan and a “Shared Interoperability Roadmap” to help guide the journey towards interoperable health IT

17. Overview of Interoperable Health ITReferences – Lecture c References Office of the National Coordinator for Health Information Technology. (2015). Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap. Office of the National Coordinator for Health Information Technology. (2015). Federal Health IT Strategic Plan 2015-2020. Charts, Tables, Figures 3.10 Figure: Office of the National Coordinator for Health Information Technology. (2015). Federal Health IT Strategic Plan cover. 3.11 Figure: Office of the National Coordinator for Health Information Technology. (2015). Federal Health IT Strategic Plan vision, mission, and goals. 3.12 Figure: Office of the National Coordinator for Health Information Technology. (2015). Federal Health IT Strategic Plan goal 4. 3.13 Figure: Office of the National Coordinator for Health Information Technology. (2015). Shared Nationwide Interoperability Roadmap cover. 3.14 Figure: Lorenzi, V. (2016). ONC Shared Nationwide Interoperability Roadmap sections. 3.15 Figure: Office of the National Coordinator for Health Information Technology. (2015). ONC Shared Nationwide Interoperability Roadmap part 1. 3.16 Figure: Office of the National Coordinator for Health Information Technology. (2015). ONC Shared Nationwide Interoperability Roadmap part 2.

18. Unit 3: Overview of Interoperable Health IT, Lecture c – National Health Interoperability Strategy This material was developed by Columbia University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 90WT0004.