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Does the ONC certification program affect interoperability? New evidence and implications

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ONC is pleased to share the findings of recently published research that sheds light on the impact that the adoption of Certified Health Information Technology (Health IT) 2015 Edition has had on hospital interoperability rates. In an article recently published in the Journal of the American Medical Informatics Association called Impact of the 2015 edition of the health information technology certification on interoperability between hospitals, we examine how the variation in adoption of Certified Healthcare IT 2015 Edition affected key measures of interoperable exchange. Our findings, described in detail in the article and summarized below, show that the availability of data exchange capabilities in EHR systems contributes significantly to greater interoperability in addition to other factors such as user and business motivation.

ONC’s Health IT Certification Program has become an important part of the Health IT ecosystem focused on meeting standards to facilitate better interoperability of health data for patient care and access. Currently, almost all hospitals and 80 percent of doctors have adopted electronic medical records (EHR) certified through the Program. Six years ago, ONC published the 2015 Edition Health IT Certification Criteria, which updated several key standards requirements, including the Statement of Applicability for Safe Health Transport (i.e. Direct Protocol) and the Architecture standards. of consolidated clinical documents (C-CDA).

Interoperability on the rise

Our research showed that nearly 40 percent of hospitals adopted 2015 Edition Certified Health IT between 2016 and 2018, increasing interoperability engagement by 18 percent.

Hospitals that switched to different EHR developers saw greater interoperability gains by adopting the 2015 Edition technology than those that did not. Between 2014 and 2018, hospital interoperability rates doubled from 23 percent to 46 percent, and study findings indicate that adoption of the 2015 Edition certified health IT was responsible for 11 percent of that increase.

Despite the rather significant effects of the adoption of certified healthcare IT in the 2015 edition, the study highlights that adoption can only go so far in expanding interoperable exchange between hospitals. The study predicted hospital interoperability rates at various adoption rates for Certified Health IT 2015 Edition. Results indicate that between 53 and 61 percent of hospitals would routinely engage in interoperable health information exchange If everyone had adopted the 2015 Edition Certified Health IT.

Latest data found that 90 percent of hospitals had adopted 2015 Edition Certified Health IT by the end of 2019. Based on this research, 55 percent of hospitals were able to electronically send, receive, find, and integrate a summary of health care records. patients from sources outside their health system. This work validates our forecast estimates. It also provides additional evidence that while the adoption of the 2015 Edition Certified Healthcare IT resulted in interoperability gains, more needs to be done to achieve widespread success.

Taking Advantage of Interoperability Gains

ONC continues to take steps to leverage the 2015 edition to promote data standards, improve data sharing, and achieve widespread interoperability.

In 2020, Final rule of the ONC Cures Act established the basic health data that must be supported by all certified health IT developers and the means by which this data must be available to patients and physicians. Known as the United States Basic Data for Interoperability (USCDI), this new standards standard specifies a set of health data classes and constituent data elements for interoperable health information exchange nationwide. (Version 2 of the USCDI was recently finalized.)

In addition to identifying the USCDI, ONC also established a new certification criteria so that the data included as part of the USCDI is available through secure and standardized application programming interfaces (APIs) for patient and population services. Together, these new aspects of the 2015 edition will support an ecosystem of applications, improve interoperability, and position patients, clinicians, and researchers to manage health data in more modern ways.

These new aspects of the 2015 Edition will support an ecosystem of applications, improve interoperability, and position patients, clinicians, and researchers to manage health data in more modern ways.

It is imperative to leverage this work to further assess and measure the effects of these policy changes on interoperability. Quantifying the impact of federal policy is a fundamental principle of the Evidence-Based Policy Foundation Act of 2018, and ONC is continually focused on improving understanding of the impact of our policies to inform future decision-making and rulemaking.

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