Interoperability is often defined as the electronic exchange of clinical data to support healthcare providers, but the American Hospital Association suggests this definition is too narrow.
In a letter to Karen DeSalvo, MD, acting assistant secretary for health and national coordinator for health IT, the AHA recommends ONC expand its scope of interoperability measurement beyond just exchanging and using electronic health information to include whether organizations have the standards, technology and infrastructure to facilitate data exchange.
The AHA wrote that this infrastructure is foundational to interoperability. "Without those building blocks in place, providers are challenged to efficiently and effectively exchange and use health information," the organization wrote.
What's more, the AHA recommends ONC expands the scope of data sharing it measures beyond data that is exchanged. Exchanging data is just one form of interoperability, according to AHA.
"Other mechanisms also can be used to accomplish the goal of ensuring that providers have access to the information they need for care. For example, hospitals and health systems are sharing information with clinicians and post-acute care providers by offering access to shared data systems. This type of sharing can be more efficient and effective than exchange, as the latest data are always available and clinicians with the appropriate access rights may access it whenever needed," the AHA wrote.
Additionally, the AHA highlights the challenges of measuring "use" of electronic health information and encourages the ONC to examine "larger proxies" to see if shared information is being used in care. For example, the AHA says participation in alternative payment models could be a measured outcome because such models will only be successful if data is successfully shared.
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