ONC Develops Health IT Protocol for Care Coordination, Interoperability

As COVID-19 underscores the need for greater interoperability, ONC is working with industry stakeholders to rapidly deploy health IT implementation guidance in support of care coordination, according to a blog post written by ONC officials Brett Andriesen and Holly Miller.

ONC’s 360X project is a series of Integrating the Health Care Enterprise (IHE) International profiles that leverage health IT standards to streamline patient care transitions, Andriesen and Miller noted. The project currently has IHE-balloted profiles for two transitions of care use cases: ambulatory referrals and acute/ambulatory transfers to skilled nursing facilities.

This past year, the 360X group focused on use cases to enhance care transitions most critically needed during the COVID-19 pandemic, Andriesen and Miller explained.

ONC and its industry partners aim to identify and complete balloting for the following two use cases for rapid deployment.

First, the 360X group is working to create an implementation guide supporting transfers of care from skilled nursing facilities to acute emergency departments, Andriesen and Miller noted.

Patient data exchange is key to streamlined care coordination. Enhanced interoperability of COVID-19 health data can also help protect the clinical staff, the ONC officials noted.

The group is also working on a social determinants of health (SDOH) needs-based referrals use case. This project aims to improve access to SDOH data within health IT workflows for more patient-centered care.

The focus of this protocol is to close the referral loop with social care entities to help ensure that patients’ SDOH needs are met, Andriesen and Miller explained.

The development focuses on identifying coded data elements and associated value sets to represent SDOH screening, diagnosis, planning, and interventions in health IT systems, which closely aligns with existing work by the Gravity Project, a community-led HL7 Fast Healthcare Interoperability Resources (FHIR) Accelerator, the blog authors noted.

Founded by the University of California San Francisco (UCSF) Social Interventions Research and Evaluation Network (SIREN) in 2018, Gravity Project consists of over 1,000 healthcare stakeholders. These stakeholders include academic and federal food insecurity experts, community-based organizations, payers, patients, providers, and health IT vendors.

At the end of 2020, Gravity Project published an implementation and recommendation guide for SDOH data and terminology that focused on food insecurity, housing instability and quality, and transportation access.

“The Gravity Project’s work to document and integrate social risk in clinical care has never been more urgent than now,” Tom Giannulli, chief medical information officer of the American Medical Association (AMA), said in a press release at the time of the announcement.

“With COVID-19, doctors see the intersection of social determinants and health status daily,” Giannulli continued. “The AMA is proud to contribute our expertise and to sponsor Gravity’s critical work.”