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ONC Releases Interoperability Standards Advisory for 2017


Standards Perspectives

Healthcare regulations and policies are very complex and ever-evolving. It’s important for managers of health plans and state Medicaid agencies to understand what new legislation means and how it affects their programs. Standards Perspectives brings you the latest details on new policies and standards so you can quickly and clearly learn what’s important to make the right decisions.


ONC Releases Interoperability Standards Advisory for 2017

The Office of the National Coordinator for Health Information Technology (ONC) recently released the 2017 Interoperability Standards Advisory (ISA). It includes essential standards and implementation specifications for technology developers and clinicians.

The ISA standards represent the model ONC will use to coordinate the identification, assessment and public awareness of interoperability standards and implementation specifications that can be used by the healthcare industry. They have been developed to address specific interoperability needs including, but not limited to, interoperability for clinical, public health and research purposes.

The advisory is a public guide to standards and specifications – both mandatory and voluntary – that ONC recommends providers and systems developers use to promote the free flow of health information.

The standards are categorized into four sections:

  • Section I: Vocabulary/Code Set/Terminology Standards and Implementation Specifications
  • Section II: Content/Structure Standards and Implementation Specifications
  • Section III: Standards and Implementation Specifications for Services
  • Section IV: Models and Profiles

Appendix I – Sources of Security Standards and Security Patterns provides information about each standard within each section:

  • Standard/Implementation Specification
  • Standards Process Maturity
  • Implementation Maturity
  • Adoption Level
  • Federally Required
  • Cost
  • Test Tool Availability

Recommendations from the ISA Task Force

Final Recommendations for 2017 have been made by the ISA Task Force, a panel of experts who perform a peer review of the ONC ISA. They generated a “final recommendation” on the standards published in the 2017 ONC ISA. The task force expects the interoperability standards to eventually evolve to a more dynamic experience for users in these areas:

  • Clinical decision support capabilities in Electronic Health Records (EHRs), including better clinician access to guidelines for identifying patients at risk for emerging infectious diseases, as well as guidance on how to better manage follow-up care for existing infectious disease cases
  • Improvement to the electronic “initial case reporting” capabilities from EHRs to public health agencies by leveraging the work of the private Digital Bridge initiative and other projects still in the early stages
  • A more consistent format to distinguish vocabulary standards for observations from vocabulary standards for observation values. For instance, organization leaders look to replace the ISA term “best available standard” with “recognized standards.”

Finally, the recommendations also include a number of references to the importance of standardizing clinical decision support (CDS) services, including using Fast Healthcare Interoperability Resources (FHIR) technology for CDS to enhance interoperability. Specifically, the task force emphasizes the relevance of Health Level 7 (HL7) standards.

Complete details on the Final Recommendations are available here.

What This Means for Medicaid

ONC is promoting interoperability in the healthcare industry by publishing the existence of relevant standards and encouraging the industry to make use of them in their solutions. Many of the standards identified primarily support codesets and clinical data sharing among hospitals and providers.

However, there are a number of standards that directly affect Medicaid, including many of the vocabulary, codeset and terminology standards. Section III has a number of categories of interest to Medicaid, including those related to Healthcare and Provider directory, Patient Identification Management and standards for Publish and Subscribe. These standards range from newly developed to very well-established.

Moreover, higher levels of MITA maturity require the use of clinical information in administrative decision making. These standards support the sharing of clinical data between Medicaid and healthcare providers.

According to ONC, the specifications should enable easier sharing of clinical data and would be useful to furthering the spread of interoperability, though it will be up to specific federal programs to decide whether, and when, the specifications are required.

You can read more Conduent insights about healthcare regulations in previous editions of Standards Perspectives.