HHS Issues Documents to Support Nationwide Health Data Exchange
HHS has issued three documents for public comment that are designed to support network-to-network health data exchange nationwide.
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- HHS has issued three documents for public comment that are designed to support network-to-network health data exchange nationwide.
The three documents are second drafts of the Trusted Exchange Framework (TEF) and the Minimum Required Terms and Conditions (MRTCs) for trusted exchange and a first draft of the Qualified Health Information Network (QHIN) Technical Framework.
ONC explained that these documents would form a single Common Agreement, which will create the baseline technical and legal requirements for sharing electronic health information on a nationwide scale across disparate networks.
“Collectively, these documents seek to provide a single ‘on-ramp’ to nationwide connectivity, while advancing a landscape where electronic health information securely follows the patient and can be queried, retrieved, and delivered when and where it is needed,” explained Don Rucker, MD, national coordinator for health information technology.
“A successful ‘network of networks’ requires that each network that facilitates connectivity agrees to the same mix of technical standards, policies, and legal conditions,” Rucker commented.
ONC will maintain the TEF, and a non-profit Recognized Coordinating Entity (RCE) will be awarded funds to develop, update, implement, and maintain the Common Agreement.
ONC plans to award the winning RCE proposal $900,000 for the first year of the contract with funding in additional years contingent on the availability of funds and completion of milestones. Applications are due to ONC by June 17, 2019.
ONC will define the minimum required terms and conditions needed to bridge the current differences among data sharing agreements that are preventing the flow of electronic health information. The RCE will be in charge of developing additional required terms and conditions to operationalize the Common Agreement and meet the interoperability requirements of the 21st Century Cures Act.
HHS Extends Comment Period for NPRM by 30 Days
Separately, HHS announced that it is extending the public comment period by 30 days for its proposed rules to promote interoperability of health IT technology.
In a notice of proposed rulemaking (NPRM) released Feb. 11, ONC laid out a series of measures intended to implement healthcare interoperability provisions of the Cures Act.
ONC proposed new application programming interface (API) certification criteria, new standards and implementation specifications, and conditions and maintenance of certification requirements.
To be certified, healthcare API developers must use the HL7 Fast Healthcare Interoperability Resources (FHIR) standards along with implementation specifications.
ONC's support for the HL7 FHIR standards for use in healthcare APIs is a “turning point” for healthcare interoperability, Intermountain CMIO Stan Huff told HITInfrastructure.com.
“I think those are good provisions. They're going to require work; everybody's not doing that yet. But I think it's a very positive step forward,” Huff said.
Interoperable healthcare APIs will have a “tremendous” impact on healthcare, added Huff.
Healthcare interoperability will reduce patient deaths caused by preventable medical errors, which he estimated at 250,000 deaths per year.
“We can save the lives of patients by implementing advanced clinical decision support, for example, to detect occult sepsis or to help diagnosis and management of pulmonary embolism. But that can’t go anywhere because the infrastructure in every system is different,” he said.
The whole healthcare enterprise nationwide and worldwide could become a learning health system because interoperability enables data to be shared seamlessly,” he said.
The NPRM also laid out conditions under which the information blocking prohibition would not apply.
The Cures Act requires that ONC develop rules so that the following communications are not restricted or prohibited by the information blocking rule: the usability, interoperability, and security of health IT; relevant information regarding users’ experience when using health IT; business practices of developers of health IT related to exchange of electronic health information, and the manner in which a health IT user employs such technology.
Several healthcare organizations had asked ONC for an extension of the comment deadline for the NPRM. In response, ONC has extended the deadline for submission of comments to June 3, 2019.
