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Monday, June 9, 2014

The ONC Ten Year Plan, comrades

In the past decade, there has been dramatic progress in building the foundation of a health IT infrastructure across the country that is resilient and flexible to accommodate many types of change. Through deliberate policy and programmatic action, the majority of meaningful use eligible hospitals and professionals have adopted and are meaningfully using health IT. This progress has laid a strong base upon which we can build. However, there is much work to do to see that every individual and their care providers can get the health information they need in an electronic format when and how they need it to make care convenient and well-coordinated and allow for improvements in overall health. There is no better time than now to renew our focus on a nationwide, interoperable health IT infrastructure – one in which all individuals, their families, and their health care providers have appropriate access to health information that facilitates informed decision-making, supports...

This significant progress has created a growing demand for interoperability that not only supports the care continuum, but supports health generally. Electronic health information needs to be available for appropriate use in solving major challenges such as providing more effective care and informing and accelerating scientific research. Despite significant progress in establishing standards and services to support health information exchange and interoperability, it is not the norm that electronic health information is shared beyond groups of health care providers who subscribe to specific services or organizations. This frequently means that patients’ electronic health information is not shared across organizational, vendor and geographic boundaries. Electronic health information is also not sufficiently standardized to allow seamless interoperability, as it is still inconsistently expressed with vocabulary, structure, and format, thereby limiting the potential uses of the information to improve health and care. We must learn from the important lessons and local successes7 of previous and current health information exchange infrastructure to improve interoperability in support of nationwide exchange and use of health information across the public and private sector...
What's not to love? Below, graphic prediction of their model.


Through our Standards & Interoperability (S&I) Framework, ONC will continue to work with industry stakeholders and federal and state governments to advance core technical standards for terminology and vocabulary, content and format, transport, and security. These standards will enable, at a minimum, the following essential services for interoperability:
  1. Methods to accurately match individuals, providers and their information across data sources
  2. Directories of the technical and human readable end points for data sources so they and the respective data are discoverable
  3. Methods for authorizing users to access data from the data sources
  4. Methods for authenticating users when they want to access data from data sources
  5. Methods for securing the data when it is stored or maintained in the data sources and in transit, i.e., when it moves between source and user
  6. Methods for representing data at a granular level to enable reuse
  7. Methods for handling information from varied information sources in both structured and unstructured formats.
You can't question the necessity of any of these. But, frustratingly, what you will not find in this entire ONC paper (pdf) is the word "dictionary" or phrase "data dictionary." See my earlier tilting-at-windmills blog post on The Interoperability Conundrum.


LOL From The Incidental Economist blog.

More to come...

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