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DeSalvo's 10-year health data interoperability plan: Can it work?

Let’s see what impact, if any, national health IT coordinator Karen DeSalvo, M.D.’s ambitious 10-year health data interoperability plan has on healthcare providers, consumers and IT vendors.

The 13-page manifesto sets out the Office of the National Coordinator for Health Information Technology’s broad vision for the way things are supposed to work together, how the nationwide mishmash of IT systems in hospitals, schools, and even prisons will eventually be able to share data easily without breaching patients’ privacy.

“It will take time to build a fully interoperable infrastructure of coordinated care and communication across healthcare providers, patients, and public health entities that improves healthcare quality, lowers healthcare costs, and improves population health,” DeSalvo said.

That’s an understatement.

DeSalvo’s roadmap, while broken out into 3-year, 6-year and 10-year segments, is an idealistic scenario that depends heavily on cooperation among the countless players in the healthcare IT community.

In addition to the federal policy makers, ONC’s plan includes state, local and tribal governments; hospitals, clinicians and researchers; and in the private sector —  tech developers, vendors and payers.

With sometimes opposing goals and competitive issues, these disparate groups can sometimes be at odds. Without clear markers or penalties, or objectives tied directly to financial disbursements, the plan could end up gathering digital dust along with other optimistic implementation schedules such as the oft-delayed rollout of ICD-10, originally slated for 2011 and currently by law can come no sooner than October 1, 2015.

DeSalvo builds her plan around five key “building blocks”:

  1. Core technical standards and functions – advancing common rules for terminology and vocabulary, content and format, and security
  2. Certification to support adoption and optimization of health IT products and services – ensuring that the broad spectrum of health IT conforms to standards for capturing and exchanging healthcare delivery
  3. Privacy and security protections for health information – identifying weaknesses and gaps in privacy protection and rolling out rules for sensitive health conditions including behavioral health and genetic information that are more stringent than the HIPAA privacy rule
  4. Supportive business, clinical, cultural, and regulatory environments – going beyond the Medicaid and Medicare EHR  Incentive Program to incentivize players to share and move information, and educating the public better about the availability of medical information
  5. Rules of engagement and governance – solidifying ONC’s oversight role under the HITECH Act

Check back in a decade and see how much was accomplished.

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