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THE OFFICE OF THE NATIONAL COORDINATOR’S ROAD MAP TO INTEROPERABILITY AND THE LEARNING HEALTH SYSTEM

ONC WEBSITE

CONSUMER KNOWLEDGE

INTEROPERABLITY

ABILITY TO SHARE HEALTH INFORMATION AMONG DIFFERENT COMPUTER SYSTEMS

LONGITUDINAL

ABILITY TO SHARE INFORMATION BETWEEN DIFFERENT PROVIDERS

2004 Executive Order 13335 2008 2005‐2008 IT Strategic Plan & HIT

• rganizations

formed 2009 HITECH ACT 2010 Blue Button 2011 Meaningful Use Stage 1 2012 CDA created 2014 Meaningful Use Stage 2

The Beginning

• f the Road

2015 Federal 2020 2015 Federal IT Strategic Plan 2015‐ 2020

Vision and Mission

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Learning Health System

The Institute of Medicine (IOM) defines a learning health system as “one in which progress in science, informatics, and care culture align to generate new knowledge as an ongoing, natural by‐product of the care experience, and seamlessly refine and deliver best practices for continuous improvement in health and health care.”

Learning Health System

An ecosystem where all stakeholders can securely, effectively and efficiently contribute, share and analyze data.

LHS Stakeholders

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

People receiving care or supporting the care

• f others

Organizations that pay for care People and Organizations that

– deliver care and services – support the public good – Generate new knowledge, whether research or quality improvement – Provide health IT capabilities – Govern, certify and/or have oversight – Develop and maintain standards

WHY A LHS

IOM statistic ‐ it currently takes 17 years for “a new validated item of biomedical knowledge with implications for health care to find its way into routine use in health care.” A learning health system could take that 17 years and bring it down to 17 months, 17 weeks or even 17 hours.

LHS in USA

Source: Charles Friedman, PhD

Health IT Ecosystem

ONC: Connecting Health Care for the Nation: A 10 Year Vision to Achieve an Interoperable Health IT Infrastructure

Roadmap Organization

Three Main Sections

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Drivers

Supportive Payment and Regulatory Environment

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Policy/Technical Components

Shared Decision‐Making, Rules of Engagement and Accountability

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Policy/Technical Components

Ubiquitous, Secure Network Infrastructure

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Policy/Technical Components

Verifiable Identity and Authentication of all Participants

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Policy/Technical Components

Consistent Representation of Authorization to Access Electronic Health Information

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Policy/Technical Components

Consistent Understanding and Technical Representation of Permission to Collect, Share and Use Identifiable Electronic Health Information

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Policy/Technical Components

An Industry‐Wide Testing and Certification Infrastructure

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Standards Categories

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Policy/Technical Components

Consistent Data Semantics

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Policy/Technical Components

Consistent Data Formats

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Policy/Technical Components

Secure, Standard Services

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Policy /Technical Components

Consistent, Secure Transport Techniques

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Policy /Technical Components

Accurate Individual Data Matching

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Policy /Technical Components

Health Care Directories and Resource Location

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Outcomes

Individuals Have Access to Longitudinal Electronic Health Information, Can Contribute to that Information, and Can Direct It to Any Electronic Location

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Outcomes

Provider Workflows and Practices Include Consistent Sharing and Use of Patient Information from All Available and Relevant Sources

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Outcomes

Tracking Progress and Measuring Success

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

The Journey Continues

2015‐2017 Send, receive, find, and use priority data domains to improve health care quality and outcomes 2018 2020 Expand 2018‐2020 Expand data sources and users in the interoperable health IT ecosystem to improve health and lower costs. time data access 2021‐2024 Achieve nationwide interoperability to enable a learning health system, with the person at the center of a system that can continuously improve care, public health, and science through real time data access Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Source: ONC Website

Source: A Shared Nationwide Interoperability Roadmap Final Version 1.0

Resources

• The “Learning Health System” as the Consummate

Informatics Challenge, Charles Friedman, PhD, University of Michigan, May 14, 2013

• www.learninghealth.org
• The Office of the National Coordinator for Health

Information Technology Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap; Final Version 1.0

• The Office of the National Coordinator for Health

Information Technology Connecting Health and Care for the Nation: A 10‐year Vision to Achieve an Interoperable Health IT Infrastructure

Questions