Sunday, December 21, 2014
As I wrote on October 23, the government faces many challenges in implementing successful health care information exchanges that improve the efficiency and effectiveness of care delivery. This first follow-up post discusses the importance of standards and

Healthcare IT news is overflowing with discussions about standards and interoperability, two of the cornerstones for advancing the benefits of digitized healthcare. Behind the scenes, the Office of the National Coordinator (ONC) Standards and Interoperability Framework is moving forward with 39 pilots generated over the past three years. While the ONC faces a diminished budget and some re-organization, a consortium of ONC staff, contract personnel, and many volunteer stakeholders from across the healthcare eco-system are collaborating to implement accepted standards and demonstrate interoperability as information is moved from one entity to another. The Health Information Technology for Economic and Clinical Health (HITECH) Act and American Reinvestment and Recovery Act of 2009 (ARRA) Information-Center promoted adoption of EHRs, bringing over 92% of hospitals and 75% of providers into the digital age – however, only about 14% exchange data outside of their organizations. This is not surprising, because the ability to exchange information was not the focus of promoting widespread EHR adoption. In the continuum of development, the Standards and Interoperability Framework led by ONC2 and continuing with broad collaboration across the healthcare ecosystem will progress. Leading organizations continue to pave the way and demonstrate the benefit of a digitized, information sharing and increasingly interoperable system. Throughout this effort close collaboration with the HL7 (Health Level 7) group ensures that the standards are vetted and usable. The introduction of FHIR (Fast Healthcare Interoperability Resources) to the HL7 toolkit moves a cumbersome process for formatting data and descriptors to an automated process that readily formats information to share in increasingly interoperable ways. The door is now wide open for EHR vendors, healthcare organizations and the many stakeholders with a vested interest in transformation in healthcare to define the future by implementing useable standards and demonstrating interoperability. Several emerging communities focus on fostering information exchange and growing interoperable capabilities. These initiatives reflect the realization that the future favors interoperable and integrated systems to deliver better outcomes and reduce the unnecessary costs in the system. Standards and interoperability are the building blocks for information sharing and use in a transformed healthcare system. Significant strides are bringing healthcare closer to the reality of EHRs that provide a comprehensive view of each patient to the healthcare team. Future posts will assess this issue in more detail, and from different perspectives. Read Keith's previous blog post, "The Government Can Drive Effective Implementation of Health Information to Improve Care." Image courtesy of pandpstock001 at