{"id":10311,"date":"2016-07-01T11:29:37","date_gmt":"2016-07-01T15:29:37","guid":{"rendered":"https:\/\/healthit-gov.go-vip.net\/buzz-blog\/?p=10311"},"modified":"2025-09-05T06:34:51","modified_gmt":"2025-09-05T06:34:51","slug":"measuring-interoperability-listening-learning","status":"publish","type":"post","link":"https:\/\/healthit.gov\/blog\/interoperability\/measuring-interoperability-listening-learning\/","title":{"rendered":"Measuring Interoperability: Listening and Learning"},"content":{"rendered":"\n<p>In April we asked for your input and comments on ways for us to measure how well our nation\u2019s health care system is doing in achieving \u201cwidespread interoperability,\u201d as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Separate from the provisions that the Department of Health and Human Services (HHS) has proposed to implement through the Quality Payment Program for payment of office-based Medicare physicians, MACRA specifically calls on HHS to establish metrics for the exchange and use of clinical information to facilitate coordinated care and improve patient outcomes between participants in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and others nationwide.<\/p>\n\n\n\n<p>We received <a href=\"https:\/\/www.regulations.gov\/docketBrowser?rpp=100&amp;so=DESC&amp;sb=docId&amp;po=0&amp;dct=PS&amp;D=HHS-ONC-2016-0008\">nearly 100 comments<\/a> from organizations and businesses all across the health and health information technology (health IT) landscape in response to our Request for Information and found that many of the comments related to four topics:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Burden: <\/strong>Do not create significant additional reporting burdens for clinicians and other healthcare providers.<\/li>\n\n\n\n<li><strong>Scope: <\/strong>Broaden the scope of measurement to include individuals and providers that are not eligible for the Medicare and Medicaid EHR Incentive Programs.<\/li>\n\n\n\n<li><strong>Outcomes: <\/strong>Identify measures that go beyond exchange of health information. Although measuring the flow of information is important, it is also critical to examine the usage and usefulness of the information that is exchanged as well as the impact of exchange on health outcomes.<\/li>\n\n\n\n<li><strong>Complexity:<\/strong> Recognize the complexity of measuring interoperability. Multiple data sources and more discussions are needed to measure interoperability fully.<\/li>\n<\/ul>\n\n\n\n<p>Based on internal analysis, external feedback, and MACRA\u2019s specific definitions of \u201cwidespread interoperability\u201d and the relevant population to be measured, we have identified two measures in particular that satisfy both the feedback we received and MACRA\u2019s specific parameters:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Measure #1: <\/strong>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.<\/li>\n\n\n\n<li><strong>Measure #2<\/strong>: Proportion of health care providers who report using the information they electronically receive from outside providers and sources for clinical decision-making.<\/li>\n<\/ul>\n\n\n\n<p>Importantly, these measures do not add to providers\u2019 reporting burden as part of their participation in federal health care programs like Medicare or Medicaid, but rather come from existing national surveys of hospitals and office-based physicians.&nbsp; These surveys are the American Hospital Association\u2019s AHA Information Technology Supplement Survey and the Center for Disease Control and Prevention\u2019s (CDC) National Center for Health Statistics\u2019 annual National Electronic Health Record Survey of office-based physicians. Both surveys have relatively high response rates and convey health care providers\u2019 perspectives on exchange and interoperability.&nbsp; As these surveys touch providers across the country in a variety of practices, they are not limited to the Medicare and Medicaid EHR Incentive Programs.<\/p>\n\n\n\n<p>Although the MACRA requirement for measuring interoperability largely focuses on \u201cmeaningful users,\u201d we are committed to advancing interoperability of health information more broadly. We will be expanding our 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.\u00a0 This measurement strategy is described in the Shared Nationwide Interoperability Roadmap \u2013 a collaboration with the private sector, states, and federal partners to identify near-term actions to advance an interoperable health system \u2013 and the Federal Health IT Strategic Plan [PDF- 1.8MB] \u2013 a joint effort by more than 35 federal offices and agencies that use or influence the use of health information technology on person-centered care, advancement of science and overall health. We look forward to engaging with stakeholders from across the health IT landscape in further depth on these efforts to provide insight into the nation\u2019s progress in ensuring that health data will flow seamlessly and securely where and when it is needed.<\/p>\n\n\n\n<p>Ultimately, these metrics will help inform the wide range of efforts underway to achieve a learning health system where information flows seamlessly and securely, including:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The <a href=\"https:\/\/healthit.gov\/interoperability\/\">pledges<\/a> made earlier this year by many private sector market leaders to make electronic health information flow better by not blocking data, implementing and using federally recognized standards, and helping consumers easily and securely access, use and share their electronic health information;<\/li>\n\n\n\n<li>Updated <a href=\"https:\/\/dashboard.healthit.gov\/dashboards\/certified-health-information-technology-developer-transparency.php\">information<\/a> from health IT developers about potential costs and implementation issues that is posted online for providers to use when purchasing health IT, and<\/li>\n\n\n\n<li>Recent <a href=\"https:\/\/healthit.gov\/\">challenges<\/a> we have issued to spur innovation of market-ready, user-friendly apps for consumers and providers and to make it easier for individuals to send their data where they wish.<\/li>\n<\/ul>\n\n\n\n<p><a href=\"https:\/\/healthit.gov\/wp-content\/uploads\/2018\/03\/fulfilling_section_106b1c_of_the_medicare_access_and_chip_reauthorization_act_of_2015_06.30.16.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Fulfilling Section 106(b)(1)(C) of the Medicare Access and CHIP Reauthorization Act of 2015 [PDF-260KB]<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In April we asked for your input and comments on ways for us to measure [&hellip;]<\/p>\n","protected":false},"author":619,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_selected_menu":"","_show_breadcrumbs":"true","_blog_show_featured_image":false,"footnotes":""},"categories":[37],"archived-category":[],"featured":[],"topics":[418,420,423],"class_list":["post-10311","post","type-post","status-publish","format-standard","hentry","category-interoperability","topics-interoperability","topics-interoperability-standards","topics-interoperability-investments"],"acf":{"blog_authors":[{"blog_author_profiles":"198527"},{"blog_author_profiles":"198647"}],"hp_news_hide":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.3 (Yoast SEO v24.8.1) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Measuring Interoperability: Listening and Learning - ONC Blog<\/title>\n<meta name=\"description\" content=\"Explore how HHS measures interoperability in health IT under MACRA with input from national surveys. Discover metrics, goals, and future strategies for improvement.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/healthit.gov\/blog\/interoperability\/measuring-interoperability-listening-learning\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Measuring Interoperability: Listening and Learning\" \/>\n<meta property=\"og:description\" content=\"Explore how HHS measures interoperability in health IT under MACRA with input from national surveys. 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