Health Information Management

AHA says ONC interoperability standards lack clarity and guidance

HIM-HIPAA Insider, November 16, 2015

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The Office of the National Coordinator (ONC) must provide greater detail on interoperability standards and work with other agencies to offer education on new standards included in meaningful use regulation, according the American Hospital Association (AHA).

The AHA criticized ONC’s draft 2016 Interoperability Standards Advisory for lacking precise descriptions of the metrics and characteristics the organization uses to determine which standards are best available, in a statement released November 6. The statement lists three specific recommendations to ONC:

  • Increase detail about characteristics and metrics used to determine best available standards
  • Indicate whether a standard is ready for use by providers
  • Provide outreach and education about the standards

ONC developed six characteristics to assess interoperability standards and report their readiness for use by providers. The AHA recommends that ONC supplement these characteristics with attributes and information that explain how to use the standards in a real-world setting. This would help providers understand how these conclusions were reached and how the standards can be implemented, the AHA argues. The statement cites ONC’s use of the designation adoption as unhelpful and vague. Many standards that show a high adoption rate have actually proven to be difficult to use and don’t meet providers’ needs. Although the standards have been adopted, they are not always successfully implemented. A useful evaluation of interoperability standards should assess the success of the standards after providers have attempted to adopt them, according to the AHA’s statement.

The Interoperability Standards Advisory does not indicate if a test tool is available for conformance testing. The absence of testing tools implies that the standard is not ready. Additionally, the lack of information about limitations associated with specific standards and implementation means providers are missing crucial knowledge. ONC should publish all testing results and show how the standards support the use cases referenced, according to the AHA.

The AHA contrasts ONC’s lack of educational materials and outreach efforts with the support and education offered by CMS leading up to ICD-10. While acknowledging that such an extensive level of support may not always be possible, the AHA says ONC must offer guidance on the consistent use of mandated interoperability standards.

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