- Health IT testing and certification are "urgently needed" to advance healthcare interoperability, according to the American Hospital Association (AHA).
The organization recently published comments on the 2015 Edition health IT certification rule proposed by the Office of the National Coordinator for Health Information Technology which identified these aspects of health IT infrastructure "as a starting point to improve interoperability."
The letter from AHA Senior Vice President of Public Policy Analysis & Development Linda E. Fishman states that an effective health IT testing and certification process should also involve end users so that hospitals, health systems, and other end users can "better understand what is being tested, and how it is being tested."
According to AHA, health IT testing has far-reaching consequences for semantic interoperability:
Using Firewalls to Strengthen Healthcare Network Security AWS Expands Healthcare Internet of Things Capabilities H2O.ai Partners with IBM on Artificial Intelligence Platform eClinicalWorks Announces Integration with CMS Blue Button 2.0 API Adopting a Proactive Approach to HIT Interoperability Challenges Using All-Flash Deployments for Health IT Infrastructure in 2018 New Healthcare Blockchain Effort to Ease Credentialing Burden Advanced Health IT Infrastructure Supports Value-Based Care New Google HIT Infrastructure Collaborations Aid Population Health How Visibility Provides Stronger Healthcare Cloud Security Planning Key for Strong Health IT Infrastructure Interoperability Healthcare Cloud Security Relies on Infrastructure Visibility New AWS Collaborations Ease Health IT Cloud Storage Options HIT Container Growth Slow But Hopeful as Management Solutions Mature Value-Based Care Needs Purposeful Health IT Interoperability Why Orgs Should Consider Healthcare Storage Tools for AI, Analytics Oracle, Ivanti Announce New Data Integration Cloud Services Ransomware Emerges as Top Health IT Infrastructure Threat New Service Could Help Hospitals with Wireless Networking Strain Red Hat Improves Container Management with OpenShift 3.4 IDBS Releases Latest Cloud-Based Research Platform for Health IT Healthcare Natural Language Processing Expects Steady Growth Microsoft Unveils Improvements to IT Infrastructure Offerings Healthcare Informatics Encourage Advanced HIT Infrastructure DICOM Web Standard Improves Vendor Neutral Archive Accessibility Selecting a Healthcare Mobile App Development Platform Healthcare Artificial Intelligence Market to Reach $20B in 2024 APIs Are the “Missing Piece” for Healthcare App Interoperability 2018 EHNAC Accreditation Impacts Secure Data Exchange Healthcare Internet of Things Influences Increased Blockchain Interest Managed Cloud Services Support Public HIT Cloud Infrastructure How Edge Computing Enhances Health IT Infrastructure Ruckus Expands Network Security with VMware, Lightspeed Systems Benefits of Virtual Desktop Infrastructure to Healthcare Major Vendors Continue Investing in Health IT Infrastructure What Cloud-Managed WLAN Has to Offer Healthcare Networks Remote Monitoring, Operations Drive Healthcare IoT Adoption WellSpan Deploys Citrix Desktop Virtualization to Speed EHR Use Distinguishing Healthcare Mobile Apps from Web, Desktop Apps Choosing Between Healthcare Public Cloud, Private Cloud Healthcare Virtual Desktop Deployments On the Rise Dropbox Supports Healthcare Data Exchange and Collaboration AMA Collaboration to Develop a Standard Data Framework Threat Intelligence Adoption Tests HIT Infrastructure Security Healthcare Virtual Reality Market to Grow at 53% CAGR to 2023 Cloud-Based Virtual Desktop Infrastructure Growing in Health IT Healthcare Data Centers Call For Cloud, Virtualization HIMSS Analytics Highlights Health IT Mobile Security Concerns All-Flash Arrays Support Data Intensive Healthcare Applications How to Deploy, Manage Healthcare Multicloud Environments Solid HIT Infrastructure Supports Population Health Management NCI Adds Lightbeam Population Health to HIT Infrastructure Health IT Outsourcing Grows for Hardware, Software, and Staff DRaaS, Storage Among Top Growing Health IT Cloud Adoptions Dell EMC Releases ECM Platform for Virtual IT Infrastructure Monetization, Analytics Support Healthcare Mobile, IoT Devices UPMC Embraces Advanced Health IT Infrastructure with New Hospitals US Government Shutdown Delays OMB Review of ONC Health IT Rule Hyperledger Adds New Health IT Members to Blockchain Project Ruckus, TrackR Release Wi-Fi IoT Device Tracking Solution How Certification, Testing Impact Health IT Interoperability Care Coordination Key for Interoperability, Patient Care Backup and Disaster Recovery Evolves with HIT Infrastructure Will Multi-Cloud Gain Traction in Health IT Infrastructure? On-Demand Care: A Growing Part of Health IT Infrastructure New Quantum Release Eases Healthcare Cloud Integration Network Connectivity, Storage Challenge Healthcare IoT Push Portland Clinic Boosts Communication about Emergency Department Visits Healthcare IoT Asset Tracking Leverages WiFi, Bluetooth Walmart Patents Healthcare Blockchain, EHR for First Responders Riverbed Acquires Xirrus to Strengthen SD-WAN Solution Digital Transformation Strains Healthcare Network Security Containers to Become a Key Part of Health IT Infrastructure? Verification, Automation Strengthen Healthcare Network Security Healthcare Virtual Mobile Infrastructure Boosts Security, Control Healthcare IT Spending Priorities Include Big Data Analytics, AI Hacker-Based Cyber Defense Increases Healthcare Data Security Avoiding the Top 3 Clinical Data Migration Mistakes Using Virtual Machines to Benefit from the Healthcare Cloud Guest Networks, IoT Deployments Challenge Health Networks Improving User Experience with Healthcare Edge Networking, AI EU Data Privacy Rule GDPR Impacts US Health IT Infrastructure Considerations for Choosing Public or Private Cloud-based EHRs Microsoft Ends Support for Windows Legacy IT Infrastructure in 2020 Android Oreo Improves Enterprise Mobility Management, Security Blockchain Vendor Efforts Center on IoT in IT Infrastructure Seacoast Health Implements New Medical Device Integration Solution Healthcare Applications to Benefit from OCI Container Standard One-Quarter of US Hospitals Lack Effective RCM Solution Clinical Communication, Collaboration Key for HIT Systems AI, Data Driven Computing Essential to Health IT Infrastructure Healthcare Blockchain Set to Digitally Transform Health IT Healthcare Blockchain, Cloud, Virtualization Top 2017 Stories Healthcare Object Storage Supports Growing Unstructured Data Choosing Healthcare Private Cloud Over Public Cloud Health IT Infrastructure Integration Systems Expected to Rise Healthcare Organizations Partner with Fujifilm for PACS, VNAs Strategies for Improving On-Premises Healthcare Storage Solutions ONC’s 2nd Interoperability Forum Focuses on FHIR API, Faxes Why Organizations Require WiFi Upgrades for Healthcare IoT
Rigorous conformance testing of EHRs and of interfaces to ancillary systems that connect to EHRs (such as laboratory information systems) is urgently needed. It will support greater confidence that certified products may be reliably used to meet regulatory and market requirements. Conformance testing for interoperability also would communicate to vendors that the products required for use in federal programs must have “built in” interoperability, rather than the current scenario in which information sharing is “added on” via multiple point-to-point interfaces post-certification.
As part of its recommendations for ONC on the subject of transparency, the organization is asking the federal agency maintain a centralized resource for sharing information about the interoperability capabilities of EHR products and vendors.
"This includes the disclosures proposed in the rule, the findings from field surveillance, and complaints received. ONC should also consider additional transparency metrics about how well EHR products and their vendors support interoperability," Fishman notes.
The AHA's remarks likewise include concerns about the influence of the EHR Incentive Programs on the ONC's approach health IT certification and testing. As a result, the organization is advocating for the federal agency to recognize the demand for health IT certification of non-meaningful user.
"From the hospital perspective, certifications that would support information exchange with other care settings that are not part of meaningful use are logical next steps," adds Fishman.
Allowing for the maturation of health IT standards and application programming interfaces (APIs) round the AHA's comments on the proposed 2015 Edition certification criteria.
According to Fishman, the immaturity of health IT standards for APIs could lead to the development of one-off APIs and the costs associated with them. The solution for maturing health IT standards is likely to come from piloting these specifications and profiles in real-world settings:
Federal programs to mature draft standards through pilots or demonstration projects would signal federal support for innovation without imposing an immature standard on the entire provider community. By relying on evidence from real-world pilots that a draft standard can be scaled for ubiquitous use and become a mature standard, the federal government can then use the regulatory process to advance use of the standard, if there is sufficient evidence that regulation is needed.
The AHA's comments on the proposed rule for health IT certification are line with its comments on the Stage 3 Meaningful Use requirements proposed by the Centers for Medicare & Medicaid Services (CMS). A consistent theme in both sets of comments is the need for a well-informed and reasonable approach to advancing health IT interoperability.