NCQA Fireside Chat: Charting the Future of Health Care Interoperability
November 8, 2024 · Maya Spieske
Earlier this year, ASTP (formerly ONC) celebrated its 20th anniversary, marking both the progress made in health IT and the continued realization of ASTP’s vision for an interoperable health care ecosystem.
Recently, we had the privilege of speaking with Micky Tripathi, Assistant Secretary for Technology Policy and Acting Chief AI Officer at HHS. Our discussion explored the evolving landscape of health care interoperability, highlighting key achievements from both the public and private sectors as well as ongoing challenges in the quest for seamless global data exchange.
Continue reading for key insights from the conversation!
Interoperability Has Progressed, But the Ceiling Keeps Rising
The U.S. health care system has made significant strides toward interoperability, but there is still much room for improvement. As Tripathi said, “The ceiling keeps rising on this, as it should.”
When asked to assign a letter grade to current health care interoperability, Tripathi gave the United States a solid “B,” emphasizing that true interoperability came only after the introduction of EHRs, which didn’t surpass a 50% adoption rate until 2015. Without these electronic systems, interoperability remained out of reach.
Incentivizing Enhanced Data Quality & Sharing
The next priority is to make existing data more usable, but organizations must be incentivized to share data that meets business needs.
“There’s no standard definition of data quality, and data quality is always in the eye of the beholder,” said Tripathi. He urges business models to incentivize higher-quality data and to shift their perception of interoperability from burden to necessity. but Tripathi cautioned that stronger incentives may be necessary if the market does not respond.
Tripathi discussed ASTP’s HTI-2 Proposed Rule, which seeks to enhance health information interoperability by integrating clinical care, administrative transactions and public health. The rule promotes payer-provider integration and collaboration between agencies like CMS and the CDC, encouraging standardized data exchange through modern APIs.
To improve national health outcomes through timely data exchange, ASTP also expanded its TEFCA standard operating procedures to incorporate additional health care operations use cases. Notably, one new use case is HEDIS reporting and the exchange of information to support HEDIS. By including HEDIS reporting in TEFCA procedures, health care organizations will gain more options for exchanging standardized, regulated clinical data at scale, ultimately improving digital quality measurement.
Creating Equitable Data Exchange Policies
Creating data exchange policies that are equitable and interoperable isn’t easy, especially when increased certification requirements can disadvantage smaller health care developers, raising costs for providers and patients.
“We believe very strongly that everyone should be able to get access to the best of what technology can offer,” Tripathi emphasized. He noted that advancements like web-based technologies and FHIR APIs are making it easier and more affordable to connect to certified EHR systems, which will improve accessibility over time.
He stressed the need for additional support for organizations with limited technical capabilities, highlighting ASTP’s collaboration with SAMHSA, which helps behavioral health providers adopt standardized technologies like USCDI+. Tripathi also advocated for open interoperability initiatives across states, allowing participation under common agreements that prioritize national scalability and collaboration between the federal government and states.
ASTP’s Vision for AI in Health Care
The discussion turned to ASTP’s role in regulating AI and advancing automation within health care systems. Tripathi explained how ASTP’s involvement began in 2021, leading to the announcement of the HTI-1 Rule in 2023, which addressed the impact of algorithmic bias on health equity and safety. To tackle these challenges, ASTP is committed to improving transparency regarding AI technologies used in certified EHR systems, with new requirements set to take effect on January 1, 2025.
Tripathi underscored the necessity for a unified AI strategy across HHS, and the importance of collaboration among agencies such as the NIH and CDC. He also addressed concerns about automation bias, where overreliance on automated systems can lead to neglect or misplaced trust, ultimately affecting health care outcomes. And he stressed the need for workforce training focused on ethical AI usage, ensuring that individuals can effectively use technology while critically analyzing automated outputs.
NCQA thanks Micky Tripathi for sharing his time and insights with our audience. We look forward to reconnecting with ASTP and the health IT community at the ASTP Annual Meeting on December 4-5 in Washington, DC.
Visit our YouTube channel to watch the full Fireside Chat recording.
