- The Office of the National Coordinator for Health IT released its 2019 Interoperability Standards Advisory on Monday. The ISA provides guidance on current and emerging standards and implementation specifications for meeting healthcare interoperability needs.
- The new version includes a number of "substantive and structural updates" considered in a fall public comment period. ONC received 74 comments, leading to nearly 400 recommendations.
- Among the key changes is a new interoperability need for sending a prescription to a pharmacy for a controlled substance.
Most of the revisions to this year's ISA edition are incremental, but a number are new, reflecting the evolving needs of providers, payers and other players in today's increasingly IT-driven healthcare environment.
The 2019 edition adds several other electronic prescribing-related interoperability needs, including prescribing using weight-based dosing, request, respond or confirm a prescription transfer and request for additional refills.
Other additions include representing relationship between patient and another person, such as a family member or caregiver, and operating rules for claims, enrollment and premium payments and to support electronic prescribing transactions.
New RSS feed functionality lets users track granular revisions in real-time. And a new Appendix IV offers links to state and local public health agencies and their interoperability initiatives.
ONC officials want the ISA to serve as an "open and transparent resource for industry," capturing the latest ideas about interoperability standards development. A 2019 Reference Edition provides a quick overview of the current ISA.
The industry is still awaiting an ONC rule to curb information blocking. The long-awaited rule to define information blocking under the 21st Century Cures Act missed a 90-day deadline for Office of Management and Budget review last month. With OMB staff furloughed by the partial government shutdown, it's not clear when that review might take place, clearing sign-off on the final rule.
Meanwhile, providers are starting to catch up with the 2015 edition EHR certification requirements for the Fast Health Interoperability Resources standard and open APIs. In an October report, ONC said nearly a third of health IT developers preparing to meet 2015 edition requirements are using FHIR — specifically FHIR 2. More than half are using FHIR combined with OAuth 2.0, the industry standard for authorization.