While the federal government and healthcare providers work toward promoting interoperability, it's important to measure results in order to show just how important it is to collective stakeholders and those who have not yet joined the VNA revolution.
The Office of the National Coordinator for Health Information Technology laid out its "Call to Action on Measurement and Evaluation of Exchange and Interoperability" in Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap. This document, known as the Interoperability Roadmap, states that the proposed framework for measuring and evaluating interoperability is based off three key areas that should be measured on an ongoing basis:
- 1. The adoption of technology like VNAs and those who enable policies to improve and increase healthcare information and image exchange with interoperable platforms.
- 2. The use of and flow of interoperable health data.
- 3. How the exchange of and improvement of interoperability has bettered the costs of medical care, both for the patient and provider.
This framework was developed to be used nationwide. The ONC is planning to follow a specific set of data across domains, yet still claims the Interoperability Roadmap measurements are flexible. Interoperability data is to be collected through federal partners, and the ONC will use the Health IT Dashboard to share its reports in order to provide information on potential gaps in exchange and interoperability, as well as suggested next steps. This collective information involves end-users of interoperability programs like VNAs (providers and individuals) and the entities who make these exchanges possible, hence the public nature of the findings.
The ONC Roadmap includes three agendas, spread out over the course of 10 years, that covers what information it hopes to learn about interoperability, and how the data will be implemented between 2015 and 2024.
- 3 Year Agenda (2015 - 2017): Establishing the best ways to gather and use a common clinical data set for the improvement of patient care quality and health.
- 6 Year Agenda (2018 - 2020): Expand the implementation of interoperable health IT to those who use it, as well as improving overall health and lowering the cost of medical care. The utilization of collected clinical data on the importance and benefits of VNAs and other healthcare information and imaging technology is crucial in this step.
- 10 Year Agenda (2021 - 2024): Establishing a nationwide learning health system.
For now, the data measurement is geared toward office-based physicians, individuals, hospitals and providers of long-term and behavioral healthcare. These demographics have been chosen because they can best send, find, receive and use the information the ONC is looking to collect on interoperability in the healthcare system. Once those data sources have been fully established and a solid method to continue garnering such information has been created, the 3-year-agenda will be complete.
Measuring success now
Currently, interoperability information is being gathered through national surveys on office-based physicians, a subset of providers for long-term care settings, individuals and hospitals. There are also program participants, like the Centers for Medicare & Medicaid Services' meaningful use policy and DIRECT Trust that report information on interoperability experiences.
Along with the three key domains of measurement listed above, there are different areas the ONC is looking into. These include the capability of behavioral healthcare providers to exchange information and images through technology like VNAs. The organization also looks at whether providers can send and receive such data with others in the industry who are currently using other systems. It's also looking into the number of individuals with access to online medical records.
Another short-term measurement involves proportions, like how many providers can easily use EHRs or utilize electronically available clinical information from outside sources on a routine basis. On an individual level, measuring doctors who find, receive and send electronic health information is also an important start of this step, as well as establishing how much information is sent with optimized health IT like VNA technology.
Lastly, the ONC plans to report on the impacts of EHRs and the state of interoperability after the 3-Year Agenda is over. This will include stating the provider-reported benefits of HIE and interoperability, such as improved quality of care, efficiency and patient safety.
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