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HL7 Calls for Further Build-out of Interoperability Infrastructure

By Frank Irving

- Standards body HL7 International wants the federal government to be more heavily involved in improving the nation’s interoperability infrastructure and has provided recommendations for doing so.

HL7 letter to Senator Lamar Alexander

In a letter to Senators Lamar Alexander (R-TN, pictured) and Patty Murray (D-WA) — chairman and ranking member, respectively, of the Committee on Health, Education, Labor and Pensions (HELP) — HL7 offered suggestions for development of an interoperable health IT infrastructure and a patient-centered health system.

The HELP Committee has been highly engaged in health IT discussions. It held full committee hearings earlier this summer on health information exchange, improving the EHR user experience and solutions to information blocking.

HL7 CEO Charles Jaffe, MD, and Board Chairman Stanley Huff, MD, signed the Aug. 28 letter to the HELP Committee. Noting progress in supporting data exchange across provider organizations, they said HL7’s work has harmonized variance between systems and improved communications. Nonetheless, Jaffe and Huff wrote that the national interoperability infrastructure is not yet fully scalable.

“[M]ore needs to be done to achieve widespread, comprehensive, complete, unambiguous, predictable exchange of data across the full spectrum of stakeholders and systems including providers, patients, payers, biomedical researchers, public health agencies, patient registries and research networks,” the HL7 leaders added.

The federal government can facilitate further development of the interoperability infrastructure in the following ways, according to HL7:

1) Place primary focus on business cases and return on investment (ROI) objectives. Past efforts to develop standards lacked clear business cases and opportunities for ROI for stakeholders, which resulted in lack of uptake and utilization. The emphasis should be on sustainable data-sharing networks.

2) Require pilot and demonstration projects before national mandates of standards and issuance of implementation guidance. Standards and implementation guides should incorporate review of practical realities before being finalized. Legislation should encourage funded pilots and projects. HL7 suggested a project that could identify and resolve the challenges of sharing genomic data across care and research communities.

3) Ensure health IT standards development organizations (SDOs) are engaged in the development of health IT standards guidance, along with other stakeholders from patient, provider and industry groups. It will take more than one SDO to assemble the needed components to drive successful interoperability. SDOs will need funding to accelerate completion and harmonization of the necessary clinical, financial and systems vocabulary/terminology to support interoperability standards.

4) Prescribe minimum requirements for standards and implementation guides that systems must be able to support. At the same time, such resources should not limit opportunities for innovation and systems’ abilities to utilize approaches based on other standards.

Jaffe and Huff also wrote that private sector initiatives must mesh with government support to accomplish comprehensive data exchange across the full spectrum of stakeholders and systems — from providers, patients and payers to researchers and public health agencies. They cited the Argonaut Project as an example of HL7 successfully collaborating with private sector health industry organizations in pursuit of standards advancement. Project participants are developing a programming interface and data services specifications to enable expanded information sharing for EHRs, documents and other health information based on the HL7 FHIR (Fast Healthcare Interoperability Resources) specification.

 

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