Sunday, January 07, 2018

It Looks Like Health Information Exchange Can Be Done Well With A Proper Interoperability Framework Like That Provided By ONC in the US.

This appeared last week:

ONC releases its Trusted Exchange Framework establishing a single ‘on ramp’ for interoperability

Jan 5, 2018 1:14pm
After several months of public meetings and industry input, the Office of the National Coordinator for Health IT has released its Trusted Exchange Framework and Common Agreement designed to improve data sharing between health information networks.
The framework (PDF), mandated by the 21st Century Cures Act, provides the policies, procedures and technical standards necessary to exchange patient records and health information between providers, state and regional health information exchanges and federal agencies.
It also aims to eliminate the burdens of costly point-to-point interactions that healthcare organizations currently face by creating a common set of practices to allow providers, patients, payers and health IT vendors to securely communicate with one another.
The voluntary framework is also an attempt to resolve some of the nagging issues inhibiting data sharing across the industry, including inconsistencies within the terms and conditions of health information networks. Genevieve Morris, principal deputy national coordinator for health information technology at ONC, compares those variations to the early days of cell phones when texting over different networks was not yet possible.
“This is just the floor of what those required terms and conditions are,” she told FierceHealthcare. “We all just have to agree to the same terms in order for that exchange to happen.”
The draft framework is broken into two sections. Part A provides guardrails and standards to “engender trust between health information networks,” addressing issues around transparency, security, patient safety, and data-driven accountability.
Part B outlines a minimum set of terms and conditions addressing authentication, trusted exchange rules and core operational policies.
More here:
There is more coverage here:

ONC releases draft Trusted Exchange Framework to aid interoperability

Published January 05 2018, 3:59pm EST
The Office of the National Coordinator for Health IT on Friday released a draft Trusted Exchange Framework to enable interoperability across disparate healthcare information networks nationally, as directed by the 21st Century Cures Act.
The draft framework is designed to support nationwide interoperability by outlining a common set of principles, as well as minimum terms and conditions for trusted data exchange. According to ONC, the document focuses on policies, procedures and technical standards that build from existing HIN capabilities and enables them to work together to provide a “single on-ramp” to patient information regardless of the HIT vendor they use or the health information exchange (HIE) with which they contract.
“Currently, there are more than 100 regional HIEs and multiple national level organizations that support exchange use cases,” states ONC’s draft Trusted Exchange Framework. “While these organizations have expanded interoperability within their particular spheres, the connectivity across all or even most of them has not been achieved. This has limited the patient health information that a provider or health system has access to, unless they join multiple networks.”
According to ONC, the proposed Trusted Exchange Framework supports the agency’s goals of achieving nationwide interoperability by—among other capabilities—having “open and accessible application programming interfaces (APIs) to encourage entrepreneurial, user-focused innovation to make health information more accessible and to improve electronic health record (EHR) usability.”
National Coordinator for HIT Donald Rucker says provisions of the Cures Act seek to advance the interoperable exchange of electronic health information, and the agency’s draft Trusted Exchange Framework will help guide the country toward interoperability.
 “It’s a national challenge—it hasn’t been easy,” said Rucker. “Folks have made some great progress, but obviously there’s a lot of work to be done. One of the approaches that ONC is taking is exactly this Trusted Exchange Framework…the very specific request of Congress.”
Genevieve Morris, ONC’s principal deputy national coordinator, said the draft document is in part the product of three public listening sessions with industry stakeholders.
After a 45-day public comment period and refinements to the draft document, a final Trusted Exchange Framework will be implemented by ONC in collaboration with a Recognized Coordinating Entity—to be selected through a competitive process—which will use the policies, procedures, technical standards, principles and goals to develop a single common agreement that qualified health information networks and their participants will voluntarily agree to adopt.
…..
In addition, ONC has released a User’s Guide to Understanding the Trusted Exchange Framework and the US Core Data for Interoperability (USCDI) Glide Path to identify a roadmap for broadening the data that can be exchanged via the TEFCA. The agency is also seeking public comment on the USCDI Glide Path.
The full article is here:
I have to say this all looks like a rational approach to getting health information to be available to all who need it. (patient, provider and payer) and it does indeed do sensible things like avoid a great big vulnerable centralized database.
You can download the 48 page Draft framework from the links provided in the text.
The ADHA might usefully have a very close look at the document to see how some / many of the ideas may assist in Australia. Does anyone know just where the ADHA is up to with their Framework – has been pretty quiet recently?
I particularly like the approach to the private sector reflected here.
David.

1 comment:

  1. This is a rarely useful bit of work, I also found this work of genius https://www.healthit.gov/isa/

    Together this make a really useful set of reference resources, far ahead of anything comming from ADHA. Perhaps devoid of any idea they have been waiting to copy this?

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