The White House Office of American Innovation on Tuesday is hosting a healthcare interoperability forum, bringing together stakeholders to discuss progress in sharing electronic health information.
Earlier this year, the Office of American Innovation—created in March 2017 by the Trump administration and directed by Jared Kushner—held White House listening sessions on the challenges to achieving interoperable health IT.
Now, Kushner’s office wants to discuss the “significant policy and operational progress” made in the intervening months and the “next steps” for achieving nationwide interoperability.
“This will be a bigger meeting and there will be more players that will be present,” says Doug Fridsma, MD, president and CEO of the American Medical Informatics Association, who will be attending the invitation-only event.
“I’m excited anytime something as mundane as interoperability comes to the attention of the White House,” observes Stan Huff, MD, chief medical informatics officer at Intermountain Healthcare, who will also be at the meeting attended by senior Administration officials. “They want to have an executive session with healthcare leaders in interoperability.”
Fridsma says there are “pockets” of interoperability around the United States where there is “good” exchange of health information, and other areas of the country where it is still a struggle.
“Every patient should be able to have a copy of their record that’s not a PDF but a computable version,” Fridsma adds. “You have to hold folks accountable to reaching that goal.”
Administration officials indicate that interoperability remains a top priority for the Centers for Medicare and Medicaid Services and the White House. At the HIMSS18 conference in March, CMS announced the launch of the MyHealthEData initiative—led by the White House’s Office of American Innovation—to put Medicare beneficiaries in control of their own health records.
“The message from (CMS Administrator) Seema Verma, which has been consistent, is about putting patients at the center of care,” notes Huff.
Mariann Yeager, CEO of The Sequoia Project, a non-profit dedicated to solving health IT interoperability, will also be attending Tuesday’s White House event.
“We’re advocates of making sure that we continue advancing and growing the connectivity that we have already in place,” says Yeager, noting that infrastructure to enable health information exchange has been laid by organizations such as Carequality, CommonWell, DirectTrust and eHealth Exchange.
CMS contends that the future of interoperability centers on the development and implementation of open application programming interfaces (APIs) to enable third-party app data access and integration empowering patients.
“Even with open APIs, we still need to have some consistency or we’re going to end up with an open API that’s proprietary vendor by vendor,” observes Yeager. “It’s about having a very thoughtful implementation strategy for what is actually going to make it plug-and-play and seamless.”
Fridsma is hopeful that open APIs will be helpful in advancing interoperability. While “it certainly will give more transparency,” he warns that “we’ve seen some behaviors that—even with APIs—are troubling.”
The White House meeting comes as the Office of Management and Budget is currently reviewing a proposed interoperability rule from the Office of the National Coordinator for Health IT. The Notice of Proposed Rulemaking on information blocking and APIs—which has been under review by OMB since September—will be available for public comment soon, according to ONC.
The rule seeks to implement certain provisions of the 21st Century Cures Act, including conditions and maintenance of certification requirements for health IT developers under ONC’s HIT Certification Program, as well as the “necessary activities that do not constitute information blocking.”
For its part, The Sequoia Project in October announced a new public-private cooperative called Interoperability Matters to identify, prioritize and collaborate on the challenges to nationwide health information exchange. The group will focus first on information blocking in anticipation of the proposed ONC rule.
“Distinguishing legitimate policy differences from information blocking requires deep understanding of complex policy, technical and business issues,” says Yeager. “Our Interoperability Matters cooperative will focus on the practical implications of information sharing practices, and it will inform information blocking public policy.”
At the same time, Fridsma emphasizes that “information blocking is not the same thing as interoperability—although, they are obviously related,” adding that “the absence of information blocking doesn’t necessarily mean that there’s interoperability.”