ONC Releases Interoperability Metrics

July 15, 2016

On July 1, 2016 representatives from the Office of the National Coordinator (ONC) for Health IT published a blog post announcing and explaining HHS‟ newly established metrics to evaluate EHR interoperability under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). 


MACRA require ONC to develop interoperability measures by July 1 of this year and set-forth specific parameters regarding how the measures should be created (which ONC has said they adhered to). 


The two metrics that will measure interoperability under MACRA are:


  • Measure #1: Proportion of health care providers who are electronically engaging in the following core domains of interoperable exchange of health information: sending; receiving; finding (querying); and integrating information received from outside sources.
  • Measure #2: Proportion of health care providers who report using the information they electronically receive from outside providers and sources for clinical decision-making. 



The ONC received over 100 comments from the public on how the measures should be created, and the comments generally focused on four main areas:


  • reducing reporting burden, 
  • broadening the scope of measurement, 
  • identifying outcomes in addition to the exchange of health information, and 
  • acknowledging the complexity of reporting. 

The ONC stated, "Ultimately, these metrics will help inform the wide range of efforts underway to achieve a learning health system where information flows seamlessly and securely." 



To make reporting as easy as possible on these measures, the ONC has stated it will use national representative provider surveys to obtain the data needed to evaluate providers on their adherence to these measures, and on their eventual progress in doing so. Providers‟ will not need to report additional data as the data will be extracted from two existing surveys:


  • The American Hospital Association's survey of hospitals' health IT usage; and,
  • The Center for Disease Control and Prevention's National Center for Health Statistics' survey of office-based physicians.



In the effort to expand interoperability to a wider base of providers, CMS selected surveys that reach providers beyond just those in the Medicare and Medicaid EHR Incentive Programs. The ONC has stated it will be expanding its “measurement efforts to include populations across the care continuum in the near-term, as well as an increased focus on outcomes in the longer-term”.


If HHS determines that the measures have not done enough to create widespread interoperability by December 31, 2018 it will publish a report on the same day the following year discussing the obstacles that continue to inhibit interoperability, and possible solutions to the ongoing problems.

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