With the exception of some grant funding and the EHR meaningful use incentive program, up until now the federal government has more or less relied on competition, market-based activities, and industry de facto standards for the evolution of health information technologies. However, two major recent actions of federal agencies will go a long way in speeding up and shaping the future of national health IT adoption and, most importantly, interoperability.
This week, the Office of the National Coordinator of Health IT (ONC) asked for public feedback as it develops a notice of proposed rulemaking (NPRM) for governance of the Nationwide Health Information Network (NwHIN) in anticipation of greater use of the NwHIN by hospitals, health care practitioners, and labs, rather than just federal agencies and their health care contractors, such as Kaiser Permanents.
ONC is asking for the public’s opinion on what voluntary “conditions for trusted exchange” should be to validate electronic health information exchanges. Having these voluntary agreed to conditions would give HIEs higher confidence that those they are exchanging data with are trusted entities, per certain criteria, such as use of technical standards and implementation specifications. The public will have 30 days to offer its views.
Promoted by ONC, the NwHIN has evolved in an ad-hoc manner as agencies, such as VA, MHS, Social Security, negotiated one-off exchanges with one another and their industry health care provider partners and labs. Implementing greater governance to ensure secure exchange of health information over the Internet through the NwHIN will pave the way for greater adoption of electronic health records and much better coordination of care, which is intended to result in better health outcomes while at the same time driving down the cost of providing health care.
The other major happening is this week, in a contract notice for a data mapping project, the VA inadvertently disclosed that earlier this year the VA and DoD signed a contract to license the 3M Health Data Dictionary, not just for VA and DoD, but for healthcare providers worldwide. The dictionary contains 36 million clinical terms, concepts and definitions. Once the cat was out of the bag, 3M issued a press release just yesterday announcing the agreement makes the “software and terminology content openly available to hospitals, health systems, physician practices, payers, vendors, and public health agencies worldwide.”
This is huge as one of the thorniest issues of electronic information exchange is not technical interoperability, but is semantic interoperability (agreement on common jargon, which then enables interoperability). This is what the industry has been needing most and the fact that the agreement opens access to all health care entities worldwide is phenomenal. The dictionary will now become the de facto standard for semantic interoperability and, as a result, the exchange of health data should grow very rapidly