These myriad initiatives, Melvin concluded, suffered from a "persistent absence of clearly defined, measurable goals and metrics" and "deficiencies in key IT management areas of strategic planning, enterprise architecture and investment management."
Government Seeks Interoperability Input
Interoperability, then, remains the biggest hurdle to efficient and effective use of healthcare IT. That's why Dr. Doug Fridsma, the director of the Office of Standards and Interoperability and the acting chief scientist in the Office of the National Coordinator for Health IT (ONC), says health IT interoperability is like designing a city.
Linking the disparate clinical, billing, administrative and email systems in use at the nation's medical centers, hospitals and independent practices isn't about individual building blueprints, Fridsma says. Since those organizations are, in effect, individual neighborhoods, it's about "zoning laws, roads and infrastructure, rules and governance, safety and protection," all of which must be implemented according to flexible standards that change incrementally (not radically) and emphasize usability and workflow.
To help build this city, during HIMSS13 the ONC released a request for information seeking ways to catalyze interoperability. Various government mandates, ranging from the meaningful use of EHR technology to the care coordination advocated in healthcare reform, depend on better health information exchange. Several avenues could be pursued, ONC notes, including Medicare, Medicaid and Children's Health Insurance Program pilot programs and an expansion of the popular Blue Button program.
With interoperability alliances, movements and projects emerging with increasing frequency, the ONC should be prepared to do some heavy reading--and, it is hoped, give the industry the guidance it needs to make data exchange easier.
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