Specificity concerns surround roadmap for learning health system

The American Hospital Association (AHA) outlined some concerns about the lack of specificity contained in the first draft of a roadmap to facilitate data exchange for a learning health system. The roadmap was created by the Office of the National Coordinator for Health Information Technology (ONC) and entitled “Connecting Health and Care for the Nation, A Shared Nationwide Interoperability Roadmap.” The AHA stated its commitment to achieving the ONC’s goals.

Information sharing

According to the AHA, hospitals have found that the electronic health record (EHR) systems obtained in the last several years do not facilitate efficient data sharing. Hospitals have already invested large amounts of money in these systems, and the “cost and complexity of the many interfaces needed to connect systems today are simply not sustainable.” The AHA’s first recommendation to the ONC is to start the roadmap by adopting the meaningful use (MU) program requirements and build from there. The existing plan starts a step ahead of where most hospitals currently are in MU stages.

Goals and areas of focus

The AHA named several areas of focus it deems most deserving of the ONC’s efforts. These include:

  • ensuring a common clinical data set based on the data currently captured by 2014 Edition certified EHRs can be shared among providers to support care delivery and new delivery models;
  • improving the performance of the Consolidated Clinical Document Architecture (C-CDA) and meaningful use regulatory requirements linked to its use;
  • further developing standards, constrained implementation specifications and education on the use of standards;
  • identifying and prioritizing use cases as a method to drive improvements in interoperability;
  • implementing more robust testing and certification in support of interoperability;
  • creating more and better transparency about how EHR vendors support interoperability;
  • developing efficient and affordable exchange networks;
  • addressing the patient identification and matching problem;
  • improving the interoperability of medical devices and EHRs; and
  • aligning the business cases for interoperability across stakeholders.

The recommendations contain an overarching theme of additional development of goals and procedures with a focus on increased specificity. This includes further collaboration with government entities, providers, and vendors to better identify barriers to progress and establish appropriate solutions.

Unnecessary provisions

The AHA strongly feels that the implementation of additional incentives or requirements on providers is unnecessary. Health Insurance Portability and Accountability Act (HIPAA) (P.L. 104-191) requirements have created a cybersecurity policy that the AHA feels is sufficient. The AHA encouraged the ONC to use the existing framework.