Tripathi: ONC Working to Boost Interoperability, COVID-19 Response

The Office of the National Coordinator for Health IT (ONC) will maintain its focus on mitigating COVID-19 through health IT while also prioritizing interoperability, National Coordinator for Health IT, Micky Tripathi, said at the ONC 2021 Annual Meeting on Monday.

Tripathi, a well-decorated health IT professional with roughly 20 years of experience, was appointed as the new national coordinator for health IT following President Joe Biden’s inauguration in January.

Tripathi described the ONC’s response to the coronavirus pandemic and how the agency will attempt to improve the vaccine scheduling process.

"First and foremost is COVID," Tripathi said. “We are supporting one of the executive orders related to ensuring a data-driven response to high consequence public health threats that we have the privilege of co-chairing with the CDC.”

Tripathi added ONC is working with CDC to develop a basic FHIR approach to vaccine scheduling.

“In particular, we are working with the industry to try to get at least an incremental improvement through a basic FHIR approach to make appointment availability available on sites like Vaccine Finder, for example,” Tripathi said.

“When you search for a vaccination, not only will you find sites that have received vaccine allocation, but you’ll also have the opportunity to go in and see how many appointments are available, go into the workflow, and schedule the appointment,” he continued.

Tripathi also said ONC is helping the White House with COVID-19 vaccine credentials.

"We're certainly not out of the woods yet," he added. "We continue to have very hard work to do."  

Tripathi identified the importance of “taking health IT to the next level” by making EHR adoption ubiquitous, delivering on the potential of FHIR-based capabilities, and making interoperability a priority by building on past accomplishments.

“One of the things that we should recognize is that there’s been tremendous progress made in interoperability,” he said. “I don’t think the industry gets enough credit for the amount of progress that’s been made in interoperability.”

The ONC leader said credit is lacking because interoperability permitted purposes remain focused on treatment purposes only, rather than the rest of the healthcare sector.

“We haven't quite figured out how to integrate all the various layers of interoperability into a seamless experience," he added.

But, Tripathi said ONC is still trying to decipher how local, state, and regional health information exchange (HIE) networks fit within nationwide networks, such as eHealth Exchange and CommonWell Health Alliance.

Looking forward, Tripathi will soon implement parts of the ONC interoperability rule that the prior administration released in March 2020.

Following a recent delay, the information blocking provisions and requirements compliance date is now set for April 5, 2021. The 2015 edition health IT certification criteria and the new standardized application programming interface (API) functionality dates are now required by December 31, 2022.

Tripathi said the ONC final rule “pushes us forward in thinking about how interoperability will be a routine thing that is widely available and easy for people to use.”

Tripathi noted that health IT professionals can leverage the Trusted Exchange Framework and Common Agreement (TEFCA) to make interoperability easier and make it more seamless, "so a user doesn't have to think about what network they're on."   

"They just have interoperability, and they don't really care about what the pipes are underneath it," he added.  

Tripathi described ONC’s alignment with federal partners and how there are both positives and negatives when engaging with specific partners.  

"On the plus side, our federal partners are learning the value of electronic health records and the ability to leverage electronic health records to do great things," he said.  

"The downside is: Our federal partners are learning the value of EHRs and the ability to leverage them to do great things," he said in jest.

Tripathi told the over 2,000 virtual attendees to send ONC ongoing feedback in the future.

"We'd like to use our collective federal muscle to keep pushing forward toward an interoperability paradigm based on industry standards in the greatest way possible," Tripathi concluded.