ONC Adds 3 Key Updates to Interoperability Standards Advisory

Following stakeholder feedback, the Office of the National Coordinator for Health Information Technology made several key updates to the Interoperability Standards Advisory (ISA), highlighted by COVID-19, public health emergency, and admission, discharge and transfer (ADT) notifications to a record locator service.

ISA is leveraged as a coordinated catalog of health IT standards and implementation specifications intended to help providers, health IT developers, and other stakeholders meet their interoperability needs.

“ONC encourages all stakeholders to implement and use the standards and implementation specifications identified in the ISA as applicable to the specific interoperability needs they seek to address,” wrote ONC. “Furthermore, ONC encourages further pilot testing and industry experience to be sought with respect to standards and implementation specifications identified as ‘emerging’ in the ISA.”

The first key update was a new ISA sub-section called the COVID-19 Novel Coronavirus Pandemic. Stakeholders can utilize this resource to look for the latest response tips in one area.

ONC is in constant scrutiny of EHR interoperability, which is especially apparent during a natural disaster or a pandemic, such as COVID-19. ONC added the Specialty Care and Settings “tag” for COVID-19 interoperability information across the ISA.

The ISA also now includes a public health emergency response section. ONC added subsections on the use of hospital and facility beds, lab operations, and population-level morbidity and mortality. The new sections aim to help emergency professionals gauge public health emergencies and improve operations under critical situations.  

In 2021, health information exchange (HIE) participants will have to reach full compliance with ADT notifications Conditions of Participation (CoP), which is included in a section of the established Centers for Medicare and Medicaid Services interoperability rule.

The requirement, which goes into effect in May 2021, requires all health facilities to direct electronic notifications to a patient’s provider once the patient is admitted, discharged, or transferred from another facility.

As a result, ONC added the ADT notifications of patient encounters to a Record Locator Service. This will help identify patient data to support alert use cases utilized by HIEs, according to ONC.

ONC also noted several interoperability revisions to the existing ISA.

“These include re-wording of some interoperability need names as well as revisions to all interoperability needs within the Administrative Standards Operating Rules subsection to reflect changes to naming conventions of Operating Rules by CAQH CORE,” wrote Brett Andriesen of the ONC.

Although there were a few key ISA updates, ONC also enhanced the ISA web platform to support the United States Core Data for Interoperability (USCDI) expansion.

“More information about the Draft USCDI V2 and the SVAP is available in the first edition of the ONC Standards Bulletin, a periodically published communication for healthcare stakeholders that includes updates about ONC health IT standards initiatives,” Andriesen explained.

The ISA also reflected the ONC’s continued focus on social determinants of health. Recently, CMS and CHIP Services’ penned a State Health Official letter that encouraged states to review SDOH standards, such as food, housing, and transportation insecurity, within the ISA.

In the 2020 ISA update, ONC added four social interoperability needs that included drug use, food insecurity, house insecurity, and transportation insecurity.

“References from other government agencies and programs to the standards included in the ISA are a prime example of how our stakeholders and users of health IT can leverage the ISA to ensure awareness and use of standards that support an interoperable health IT ecosystem,” Andriesen concluded. “Your continued engagement through the ongoing public comment process is necessary to ensure the ISA remains accurate and up to date.”

ONC said it will continue to accept feedback to update the ISA throughout the year.