Advancing Interoperability via Data & Measurement

National Survey of Health Information Exchange Organizations (HIO)
Sponsor: Office of the National Coordinator for Health IT (ONC) 

Electronic health information exchange (HIE) is one of three goals specified by Congress in the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act to ensure that the $30 billion federal investment in electronic health records (EHRs) results in higher-quality, lower-cost care. The ability of providers to share data electronically is a core goal of HITECH and a central feature of a high-performing healthcare delivery system. Gaining insights into information blocking practices undertaken by provider organizations and health IT developers, the implementation of and use of standards to enable interoperability, the role of HIOs in supporting information exchange, and the sustainability and governance of HIOs is essential in supporting efforts to enable interoperability and exchange. Over the past eight years, our team has conducted five nationwide surveys of organizations working to promote HIE to determine the state of current efforts, scope of activities, and financing. The most recent findings were published in the March 2016 issue of Health Affairs and offered an independent, comprehensive evaluation of HIE progress.The nationwide survey of HIOs will enable us to focus on new achievements and identify challenges to create a current and accurate picture of HIE efforts. 

National Survey of Health Information Exchange Organizations (HIO)
Sponsor: Office of the National Coordinator for Health IT (ONC) 

Federal policy efforts continue to advance interoperable information sharing across our healthcare system, with recent efforts focused on a national trust framework (TEFCA) and improving public health reporting in response to COVID. The goal of this project is to collect timely, national data from the ~100 health information organizations across the U.S. to measure their capabilities related to sharing different types of clinical data across a broad set of healthcare stakeholders. We will also collect data on use of standards, information blocking, and sustainability.

The Market Transparency Project for Health IT Interoperability Services Cooperative Agreement Program 
Sponsor: Office of the National Coordinator for Health IT (ONC) 

The 2009 HITECH Act sought to promote nationwide adoption and effective use of interoperable electronic health records (EHRs). While EHR adoption has substantially increased, particularly among hospitals, the ability to move data across EHRs to support frontline clinical care and the ability to move data between EHRs and other systems and applications that support patient engagement, public health, research, and a wide variety of other health-related purposes has been substantially more limited. This project focuses on increasing transparency of interoperability functionality/services. The final result of our project will be an independent, open, online resource. 

Private Sector Strategies to Advance Interoperability and Data Access
Sponsor: The Healthcare Leadership Council and the Bipartisan Policy Center  

Advancing interoperability of systems and electronic information sharing in the U.S. is critical to support: 1. Better health outcomes for individuals in the U.S.; and 2. Higher quality, safer, more cost-effective care for individuals and populations. This project will help inform health information sharing priorities for those who deliver, receive, and pay for care, a vision or desired future state, key measures to help us determine whether we’ve made national progress against our vision and key legislative or regulatory policy actions that are needed – by the private sector and by government. 

Developing Measures of HIE in the State of California
Sponsor: Blue Shield of California Foundation 

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 was created to stimulate the adoption of electronic health records (EHRs) and supporting technology, including health information exchange organizations (HIOs). With the HITECH funding available until 2021, California Department of Healthcare Services (DHCS) is applying to CMS for funding to subsidize providers’ cost of implementing HIOs and expects roughly $50 Million in federal and state funds to support improvements in health information exchange by promoting the meaningful use of EHR. This project will generate knowledge of the health information exchange landscape in California and help inform the development of a measurement framework to measure HIE progress in California.

Strengthening the Technical Advancement and Readiness of Public Health via Health Information Exchange Program (STAR HIE Program)
Sponsor: Office of the National Coordinator for Health IT (ONC) 

EMI Advisors LLC has partnered with the Center for Clinical Informatics and Improvement Research (CLIIR) and the Center for Digital Health Innovation (CDHI) at the University of California San Francisco (UCSF) to support the Office of the National Coordinator for Health Information Technology’s (ONC) Strengthening the Technical Advancement and Readiness of Public Health via Health Information Exchange Program (STAR HIE Program). The U.S. Department of Health and Human Services awarded cooperative agreements to five (5) health information exchange organizations (HIEs) to help support state and local public health agencies in their efforts to respond to public health emergencies including disasters and pandemics such as COVID-19. CLIIR and CDHI will lead the evaluation by developing an independent qualitative and quantitative assessment of the recipients’ program efforts and impact.

Reconnaissance for the ONC about Effectiveness, Interoperability, and Value of Health Information Technology
Sponsor: Office of the National Coordinator for Health IT (ONC) 

ONC plays a critical role in the collection of nationally representative data to measure the adoption, use, and impact of health IT tools across care settings. Measurement and evaluation efforts serve a range of purposes – including informing federal, state, and local policymakers and policymaking, guiding private sector efforts, and fueling research. Within ONC’s measurement portfolio, the routine survey of U.S. office-based physicians is a foundational component given the focus under the HITECH Act on advancing electronic health record (EHR) use and interoperability among Eligible Providers. As further policymaking has occurred, under the ACA, 21st Century Cures, and related regulations, this survey is unique in the ability to understand the impact on frontline clinicians in a variety of office settings. Going forward, new topics require current, nationally representative data from office-based physicians, such as the use of telehealth in response to COVID, adoption and use of APIs, and HIT interoperability. This project will measure the use, impacts, and level of interoperability for HIT among U.S. office-based physicians to inform federal health IT policies and identify disparities.