When the ONC launched the Interoperability Standards Advisory (ISA), the resource focused “explicitly on clinical health IT systems’ interoperability” and provided limited information and guidance on the standards and interoperability needs it defined.
In the three years since its creation, the ISA
• expanded on the characteristics of the standards and specifications listed;
• broadened the number of interoperability needs; and
• shifted from a static document updated annually to one that can more readily respond and adopt stakeholder feedback via a dynamic tool online.
As we look toward 2018, ONC is planning to expand even further with the additions of new stakeholders and resources to improve usability of the ISA and recently requested feedback on these additions. HIMSS has shared comments on how to improve upon these updates to further interoperability within the healthcare ecosystem.
ISA expands stakeholder representation with new consumer and payer sections
The addition of an ISA subsection on Consumer Access/Exchange of Health Information is a logical expansion, as the ecosystem shifts to place the individual, or person, at the center of their care. This new subsection includes four Interoperability Needs related to a consumer’s access and ability to share generated health data with clinicians. HIMSS agrees these are a welcome addition, but there is still work to ensure that the ISA addresses the wide variety of consumer use cases, and leverages all appropriate standards.
For the past few years, ONC has been clear that the ISA “does not include within its scope administrative/payment-oriented interoperability purposes” (see 2017 ISA). For 2018, ONC has expanded the ISA’s scope to incorporate guidance on Administrative Standards and Implementation Specifications. This section includes a wide range of claims and non-claims based transactions.
Appendix II provides a start for education to the industry
Beyond the new standards, interoperability needs and stakeholders represented in the ISA, ONC has moved to make the ISA more useful by including educational resources on the standards included in the document.
The first resource included in this section defines the role of “Observation” and “Observation Value” standards, often represented by LOINC® and SNOMED CT® respectively. Leveraged throughout the Vocabulary section of the ISA, this added explanation is a welcome addition to allow developers and ISA users to understand the justification for these standard pairs.
The second resource discusses emerging API-based standards, which explains details of the emerging HL7 FHIR® standard and specifications. We definitely expect ONC will add more resources to this appendix based on feedback from stakeholders.
More to come in 2018
These recent additions are a taste of the updates we can expect to find in the 2018 Reference Edition of the Interoperability Standards Advisory, scheduled for release in January 2018. Based on the feedback submitted by HIMSS and many other stakeholders across the healthcare community, we look forward to the many more changes to this resource in the future.
Check out the full HIMSS response to the ONC ISA.
Interested in contributing your expertise to the HIMSS review of the ISA? Email firstname.lastname@example.org to learn how to become involved.