The following is a guest blog post by Steve Sisko (@ShimCode and www.shimcode.com).
Yesterday the Office of the National Coordinator for Health Information Technology (ONC) hosted an open chat to discuss their DRAFT 2017 Interoperability Standards Advisory (ISA) artifacts. The chat was moderated by Steven Posnak, Director, Office of Standards and Technology at Office of the National Coordinator for Health Information and used the #ISAchat hashtag under the @HealthIT_Policy account. The @ONC_HealthIT Twitter account also weighed in.
It was encouraging to see that the ONC hosted a tweetchat to share information and solicit feedback and questions from interested parties. After a little bit of a rough start and clarification of the objectives of the chat, the pace of interactions increased and some good information and ideas were exchanged. In addition, some questions were raised; some of which were answered by Steven Posnak and some of which were not addressed.
What’s This All About?
This post summarizes all of the tweets from the #ISAchat. I’ve organized the tweets as best as I could and I’ve excluded re-tweets and most ‘salutatory’ and ‘thank you’ tweets.
Note: The @hitechanswers account shared a partial summary of the #ISAchat on 8/31/16 but it included less than half of the tweets shared in this post. So you’re getting the complete scoop here.
Topic 1: Tell us about the ISA (Interoperability Standards Advisory) | ||
Account | Tweet | Time |
@gratefull080504 | Question: What is the objective of #ISAchat? | 12:04:35 |
@onc_healthit | To spread the word and help people better understand what the ISA is about | 12:05:00 |
@gratefull080504 | Question: What are today’s objectives, please? | 12:08:43 |
@onc_healthit | Our objective is to educate interested parties. Answer questions & hear from the creators | 12:11:02 |
@johnklimek | “What’s this I hear about interoperability?” | 12:12:00 |
@cperezmha | What is #PPDX? What is #HIE? What is interoperability? What is interface? #providers need to know the differences. Most do not. | 12:14:41 |
@techguy | Who is the target audience for these documents? | 12:44:06 |
@healthit_policy | HITdevs, CIOs, start-ups, fed/state gov’t prog admins. Those that have a need to align standards 4 use #ISAchat | 12:46:18 |
@ahier | No one should have to use proprietary standards to connect to public data #ISAchat | 12:46:19 |
@shimcode | Reference Materials on ISA Ok then, here’s the “2016 Interoperability Standards Advisory” https://t.co/5QkmV3Yc6w |
12:07:19 |
@shimcode | And here’s “Draft 2017 Interoperability Standards Advisory” https://t.co/TUFidMXk0j | 12:07:38 |
@stephenkonya | #ICYMI Here’s the link to the @ONC_HealthIT 2017 DRAFT Interoperability Standards Advisory (ISA): https://t.co/VTqdZHUjBW | 12:10:57 |
@techguy | Question: Do you have a good summary blog post that summarizes what’s available in the ISA? | 12:52:15 |
@onc_healthit | We do! https://t.co/vVW6BM5TFW Authored by @HealthIT_Policy and Chris Muir – both of whom are in the room for #ISAchat | 12:53:15 |
@healthit_policy | Good? – The ISA can help folks better understand what standards are being implemented & at what level | 12:06:29 |
@healthit_policy | Getting more detailed compared to prior versions due largely to HITSC & public comments | 12:29:48 |
@healthit_policy | More work this fall on our side to make that come to fruition. In future, we’re aiming for a “standards wikipedia” approach | 12:33:03 |
@survivorshipit | It would be particularly helpful to include cited full documents to facilitate patient, consumer participation | 12:40:22 |
@davisjamie77 | Seeing lots of references to plans to “explore inclusion” of certain data. Will progress updates be provided? | 12:50:00 |
@healthit_policy | 1/ Our next milestone will be release of final 2017 ISA in Dec. That will rep’snt full transition to web | 12:51:15 |
@healthit_policy | 2/ after that future ISA will be updated more regularly & hopefully with stakeholder involved curation | 12:52:21 |
@bjrstn | Topic: How does the ISA link to the Interoperability Roadmap? | 12:51:38 |
@cnsicorp | How will #ISA impact Nationwide Interoperability Roadmap & already established priorities? | 12:10:49 |
@healthit_policy | ISA was 1st major deliverable concurrent w/ Roadmap. Will continue to b strong/underlying support to work | 12:13:49 |
@healthit_policy | ISA is 1 part of tech & policy section of Roadmap. Helps add transparency & provides common landscape | 12:53:55 |
@healthit_policy | Exciting thing for me is the initiated transition from PDF to a web-based/interactive experience w/ ISA | 12:30:51 |
@onc_healthit | Web-based version of the ISA can be found here: https://t.co/F6KtFMjNA1 We welcome comments! | 12:32:04 |
@techguy | Little <HSML> From a Participant on the Ease of Consuming ISA Artifacts So easy to consume! |
12:40:57 |
@healthit_policy | If I knew you better I’d sense some sarcasm 🙂 that said, working on better nav approaches too | 12:43:36 |
@techguy | You know me well. It’s kind of like the challenge of EHRs. You can only make it so usable given the reqs. | 12:45:36 |
@shimcode | I think John forgot to enclose his tweet with <HSML> tags (Hyper Sarcasm Markup Language) | 12:46:48 |
@ahier | Don ‘t Use My Toothbrush! OH (Overheard) at conference “Standards are like toothbrushes, everyone has one and no one wants to use yours” |
13:15:43 |
Topic 2: What makes this ISA different than the previous drafts you have issued? | ||
Account | Tweet | Time |
@cnsicorp | #Interoperability for rural communities priority | 12:32:40 |
@healthit_policy | Rural, underserved, LTPAC and other pieces of the interoperability puzzle all important #ISAchat | 12:35:33 |
@cnsicorp | “more efficient, closer to real-time updates and comments…, hyperlinks to projects…” | 12:47:15 |
@shimcode | Question: So you’re not providing any guidance on the implementation of interoperability standards? Hmm… | 12:21:10 |
@gratefull080504 | Question: Are implementation pilots planned? | 12:22:51 |
@healthit_policy | ISA reflects what’s out there, being used & worked on. Pointer to other resources, especially into future #ISAchat | 12:24:10 |
@ahier | The future is here it’s just not evenly distributed (yet) #ISAchat | 12:25:15 |
@healthit_policy | Yes, we put out 2 FOAs for High Impact Pilots & Standards Exploration Awards | 12:25:56 |
@healthit_policy | HHS Announces $1.5 Million in Funding Opportunities to Advance Common Health Data Standards. Info here: https://t.co/QLo05LfsLw | |
Topic 3: If you had to pick one of your favorite parts of the ISA, what would it be? | ||
Account | Tweet | Time |
@shimcode | The “Responses to Comments Requiring Additional Consideration” section. Helps me understand ONC’s thinking. | 12:45:32 |
@healthit_policy | Our aim is to help convey forward trajectory for ISA, as we shift to web, will be easier/efficient engagement | 12:47:47 |
@healthit_policy | Depends on sections. Some, like #FHIR, @LOINC, SNOMED-CT are pointed to a bunch. | 12:49:15 |
@gratefull080504 | Question: What can patients do to support the objectives of #ISAchat ? | 12:07:02 |
@gratefull080504 | Question: Isn’t #ISAChat for patients? Don’t set low expectations for patients | 12:10:44 |
@gratefull080504 | I am a patient + I suffer the consequences of lack of #interoperability | 12:12:26 |
@healthit_policy | Certainly want that perspective, would love thoughts on how to get more feedback from patients on ISA | 12:12:35 |
@gratefull080504 | What about patients? | 12:13:03 |
@gratefull080504 | First step is to ensure they have been invited. I am happy to help you after this chat | 12:13:57 |
@survivorshipit | Think partly to do w/cascade of knowledge–>as pts know more about tech, better able to advocate | 12:15:21 |
@healthit_policy | Open door, numerous oppty for comment, and representation on advisory committees. #MoreTheMerrier | 12:15:52 |
@gratefull080504 | I am currently on @ONC_HealthIT Consumer Advisory Task Force Happy to contribute further | 12:17:08 |
@healthit_policy | 1 / The ISA is technical in nature, & we haven’t gotten any comments on ISA before from patient groups | 12:08:54 |
@healthit_policy | 2/ but as we look to pt generated health data & other examples of bi-directional interop, we’d like to represent those uses in ISA | 12:09:51 |
@resultant | TYVM all! Trying to learn all i can about #interoperability & why we’re not making progress patients expect | 13:09:22 |
@shimcode | Question: Are use cases being developed in parallel with the Interoperability Standards? | 12:13:28 |
@shimcode | Value of standards don’t lie in level of adoption of std as a whole, but rather in implementation for a particular use case. | 12:16:33 |
@healthit_policy | We are trying to represent broader uses at this point in the “interoperability need” framing in ISA | 12:18:58 |
@healthit_policy | 2/ would be great into the future to have more detailed use case -> interop standards in the ISA with details | 12:19:49 |
@healthit_policy | Indeed, royal we will learn a lot from “doing” | 12:20:40 |
@shimcode | IHE Profiles provide a common language to discuss integration needs of healthcare sites and… Info here: https://t.co/iBt2m8F9Ob | 12:29:12 |
@techguy | I’d love to see them take 1 section (say allergies) and translate where we’d see the standards in the wild. | 12:59:04 |
@techguy | Or some example use cases where people want to implement a standard and how to use ISA to guide it. | 13:00:38 |
@healthit_policy | Check out links now in ISA to the Interop Proving Ground – projects using #ISAchat standards. Info here: https://t.co/Co1l1hau3B | 13:02:54 |
@healthit_policy | Thx for feedback, agree on need to translate from ISA to people seeing standards implemented in real life | 13:01:08 |
@healthit_policy | Commenting on ISA Artifacts We want to make the #ISA more accessible, available, and update-able to be more current compared to 1x/yr publication |
12:34:22 |
@cperezmha | #interoperability lowers cost and shows better outcomes changing the culture of healthcare to be tech savvy is key | 12:35:10 |
@healthit_policy | One new feature we want to add to web ISA is citation ability to help document what’s happ’n with standards | 12:37:12 |
@shimcode | A “discussion forum” mechanism where individual aspects can be discussed & rated would be good. | 12:39:53 |
@healthit_policy | Good feedback. We’re looking at that kind of approach as an option. ISA will hopefully prompt debate | 12:40:50 |
@shimcode | Having to scroll through all those PDF’s and then open them 1 by 1 only to have to scroll some more is VERY inefficient. | 12:41:25 |
@shimcode | Well, I wouldn’t look/think too long about it. Adding that capability is ‘cheap’ & can make it way easier on all. | 12:43:48 |
@shimcode | Question: What Can Be Learned About Interoperability from the Private Sector? Maybe @ONC_HealthIT can get input from Apple’s latest #healthIT purchase/Gliimpse? What do they know of interoperability? |
12:19:13 |
@healthit_policy | > interest from big tech cos and more mainstream awareness is good + more innovation Apple iOS has CCDA sprt | 12:22:59 |
@drewivan | Testing & Tools I haven’t had time to count, but does anyone know approximately how many different standards are included in the document? |
12:47:29 |
@healthit_policy | Don’t know stat off had, but we do identify and provide links for test tools as available. | 12:56:31 |
@drewivan | And what percentage of them have test tools available? | 12:54:38 |
@shimcode | According to the 2017 ISA stds just released, a tiny fraction of them have test tools. See here: https://t.co/Jbw7flDuTg | 12:58:02 |
@shimcode | I take back “tiny faction” comment on test tools. I count 92 don’t have test tools, 46 do. No assessment of tool quality though. | 13:08:31 |
@healthit_policy | Testing def an area for pub-private improvement, would love to see # increase, with freely available too | 12:59:10 |
@techguy | A topic near and dear to @interopguy’s heart! | 12:59:54 |
@resultant | Perhaps we could replace a couple days of HIMSS one year with #interoperability testing? #OutsideBox | 13:02:30 |
Walk on Topic: Promotion of ISA (Thank you @cperezmha) What can HIE clinics do to help other non-users get on board? Is there a certain resource we should point them too to implement? |
||
Account | Tweet | Time |
@davisjamie77 | Liking the idea of an interactive resource library. How will you promote it to grow use? | 12:35:57 |
@healthit_policy | A tweetchat of course! 😉 Also web ISA now linking to projects in the Interoperability Proving Ground | 12:39:04 |
@davisjamie77 | Lol! Of course! Just seeing if RECs, HIEs, other #HIT programs might help promote. | 12:40:44 |
@healthit_policy | Exactly… opportunities to use existing relationships and comm channels ONC has to spread the word | 12:41:28 |
@stephenkonya | Question: How can we better align public vs private #healthcare delivery systems through #interoperability standards? | 12:42:23 |
Miscellaneous Feedback from Participants | ||
Account | Tweet | Time |
@ahier | Restful APIs & using JSON and other modern technologies | 12:54:03 |
@waynekubick | Wayne Kubick joining from #HL7 anxious to hear how #FHIR and #CCDA can help further advance #interoperability. | 12:11:30 |
@resultant | We all do! The great fail of #MU was that we spent $38B and did not get #interoperability | 12:14:21 |
@waynekubick | SMART on #FHIR can help patients access and gain insights from their own health data — and share it with care providers. | 12:17:44 |
@resultant | I think throwing money at it is the only solution… IMHO providers are not going to move to do it on their own… | 12:20:44 |
@shimcode | @Search_E_O your automatic RT’s of the #ISAChat tweets are just clouding up the stream. Why? smh | 12:08:30 |
@ahier | Do you see #blockchain making it into future ISA |
12:28:02 |
@healthit_policy | Phew… toughy. lots of potential directions for it. Going to segue my response into T2 | 12:28:58 |
@hitpol | #blockchain for healthcare! ➡ @ONC_HealthIT blockchain challenge. Info here: https://t.co/vG60qRAqqa | 12:31:33 |
@healthit_policy | That’s All Folks! Thank you everyone for joining our #ISAchat! Don’t forget to leave comments. PDF version |
About Steve Sisko
Steve Sisko has over 20 years of experience in the healthcare industry and is a consultant focused on healthcare data, technology and services – mainly for health plans, payers and risk-bearing providers. Steve is known as @ShimCode on Twitter and runs a blog at www.shimcode.com. You can learn more about Steve at his LinkedIn page and he can be contacted at shimcode@gmail.com.