In the past weeks, the Office of the National Coordinator of Health Information Technology (ONC) published an ambitious, lucid, and fairly comprehensive roadmap to IT interoperability across the country. It follows a 2014 commitment to interoperability and "proposes critical actions that the public and private sector need to take to advance the country towards an interoperable health IT ecosystem over the next 10 years."
The key components of the roadmap are:
- Establishing standards and "rules of engagement."
- Creating the conditions for good, safe, seamless sharing of electronic health information for “small” (individual patient), “big” (population level and beyond) and “long” data (wrapping around the individual and telling their health story over time).
- Motivating the use of those standards through appropriate incentives.
- Aligning states in policy, payment, and other levers.
- Making data more portable and transferrable.
- Creating a trusted environment for the collecting, sharing and using of electronic health information.
Quite honestly, we're incredibly excited to see this kind of conversation happening at the governmental level. For so many years it seemed that the government was willfully ignoring health IT and telemedicine.
When managed care, care coordination, and PMPM payments are such big focuses, there must also be constructive conversation about IT interoperability.
To achieve this, however, the health IT community must expand its focus beyond institutional care delivery and health care providers, to a broad view of person-centered health. This shift is critical for at least two reasons:
- Health care is being transformed to deliver care and services in a person-centered manner and is increasingly provided through community and home-based services that are less costly and more convenient for individuals and caregivers.
- Most determinants of health status are social and are influenced by actions and encounters that occur outside traditional institutional health care delivery settings, such as in employment, retail, education and other settings.
This shift requires a high degree of information sharing between individuals, providers and organizations. It is vital that a high degree of interoperability exists between many different types of health IT, such that systems can exchange and use electronic health information without special effort on the part of the user.
The goal of this shift is to a nationwide learning health system—an environment that links the care delivery system with community and societal supports in "closed loops" of electronic health information flow, at many different levels, to enable continuous learning and improved health. This kind of system allows individuals to select platforms and apps to share and use their own electronic health information to meet their needs without undue constraints.
In other words, we need to remember that healthcare is about people. And people have human lives with human complexities that happen outside of institutional settings. To do coordinated care well, that's the reality of the context. And that's why we support medical collaboration that uses hybrid store-and-forward telemedicine® as a key part of health IT. It's the most efficient path to keeping the patient at the center of the technology -- and allowing interoperability to emerge from that center point.
If you're curious how health IT and telemedicine can actually contribute to that kind of person-centered approach, watch our 60-second primer:
Image courtesy of automania on Flickr, used under Creative Commons rights.