For Interoperability Standards Advisory, ONC aims for Wikipedia style

An influential collection of interoperability specifications is saying goodbye to PDF format and hello to an interactive approach that echoes Wikipedia's content.

That update was among the highlights of a Twitter chat held by the Office of the National Coordinator for Health Information Technology (ONC) to discuss the new draft of the 2017 Interoperability Standards Advisory (ISA), which is the model by which ONC coordinates the identification, assessment and determination of recognized interoperability standards.

In broad terms, the Interoperabilty Standards Advisory creates a list of specifications to help achieve clinical health information interoperability. The2017 Interoperability Standards Advisory is a compilation of feedback that ONC received from public comments on the 2016 Interoperability Standards Advisory and from current deliberations from the HIT Standards Committee. ONC will accept public comments until 5 p.m. ET on Monday, October 24, 2016.

Steven Posnack, the director of the office of standards and technology at ONC, hosted ONC's Twitter chat last week and informed participants about the patient's role in the deliberations.

1 / The ISA is technical in nature, & we haven't gotten any comments on ISA before from patient groups #ISAchat https://t.co/lzVmPYSEMn

— Steven Posnack (@HealthIT_Policy) August 30, 2016

2/ but as we look to pt generated health data & other examples of bi-directional interop, we'd like to represent those uses in ISA #ISAchat

— Steven Posnack (@HealthIT_Policy) August 30, 2016

Posnack also explained how ONC is looking to make the new version of the ISA different than past versions -- namely heading away from the stagnant, 80-page PDF format of the 2016 edition.

Getting more detailed compared to prior versions due largely to HITSC & public comments #ISAchat https://t.co/HQOTaNCLsp

— Steven Posnack (@HealthIT_Policy) August 30, 2016

Exciting thing for me is the initiated transition from PDF to a web-based/interactive experience w/ ISA #ISAchat https://t.co/HQOTaNCLsp

— Steven Posnack (@HealthIT_Policy) August 30, 2016

More work this fall on our side to make that come to fruition. In future, we're aiming for a "standards wikipedia" approach #ISAchat

— Steven Posnack (@HealthIT_Policy) August 30, 2016

We want to make the #ISA more accessible, available, and update-able to be more current compared to 1x/yr publication #ISAchat

— Steven Posnack (@HealthIT_Policy) August 30, 2016

Participants in the Twitter chat bemoaned what they viewed as the failures of meaningful use, pointing out that despite the government spending billions of dollars on the program, interoperability was not achieved. However, one participant believed that spending so much money is the only way to get healthcare organizations to share medical records.

We all do! The great fail of #MU was that we spent $38B and did not get #interoperability #ISAChat @gratefull080504 @ONC_HealthIT

— Joe Lavelle (@Resultant) August 30, 2016

I think throwing money at it is the only solution... IMHO providers are not going to move to do it on their own... #ISAChat

— Joe Lavelle (@Resultant) August 30, 2016

Participants also discussed possible solutions to creating interoperability.

One major topic of discussion was standards, their role in increasing interoperability and possible use cases in the industry. Some participants felt that SMART on FHIR, a standards-based application platform that also uses APIs to make interoperability possible, is a viable solution; others felt standards need to be implemented for a particular use case in order to be successful. Posnack explained that ONC is trying to represent broader uses of standards when it comes to interoperability.

SMART on #FHIR can help patients access and gain insights from their own health data -- and share it with care providers. #ISAchat

— Wayne Kubick (@WayneKubick) August 30, 2016

We are trying to represent broader uses at this point in the "interoperability need" framing in ISA #ISAchat https://t.co/pKGCbHLme2

— Steven Posnack (@HealthIT_Policy) August 30, 2016

No one should have to use proprietary standards to connect to public data #ISAchat

— Brian Ahier (@ahier) August 30, 2016

One participant wondered whether blockchain would make it into future versions of the ISA and whether the technology would play a role in creating interoperability. Some health IT experts believe that one use case for blockchain is creating interoperability.

Do you see #blockchain making it into future ISA #ISAchat

— Brian Ahier (@ahier) August 30, 2016

phew... toughy. lots of potential directions for it. Going to segue my response into T2 #ISAchat https://t.co/5jEW8nzBZj

— Steven Posnack (@HealthIT_Policy) August 30, 2016

Other solutions that participants discussed include APIs and getting companies such as Apple involved.

restful APIs & using JSON and other modern technologies #ISAchat

— Brian Ahier (@ahier) August 30, 2016

> intrst from big tech cos and more mainstream awareness is good + more innovation Apple iOS has CCDA sprt #ISAchat https://t.co/3dk7eOP3FE

— Steven Posnack (@HealthIT_Policy) August 30, 2016

The 2017 draft of the ISA can be found on ONC's website.