HHS' Office of the National Coordinator for Health Information Technology is continuing the industry's push to incorporate social factors that influence health—like food insecurity and homelessness—into patient care.
The 2020 edition of the ONC's interoperability standards advisory, a collection of agency-recognized interoperability standards and implementation specifications, includes resources to support sharing information on four new categories of data related to social determinants: drug use, food insecurity, housing insecurity and transportation insecurity.
"As factors like these can greatly impact one's overall health, ensuring this information is known, and captured in clinical systems and available to providers is important," wrote the ONC's Steven Posnack, deputy national coordinator for health IT, and Brett Andriesen, standards advisory lead, in a blog post announcing the changes.
That hits at a suggestion healthcare groups had submitted to the agency late last year, calling for the ISA to be updated with more information on sharing patient data beyond traditional clinical care.
Adding resources to help standardize data-sharing for social factors is a step in the right direction, said Dr. John Halamka, president of Mayo Clinic Platform, the Rochester, Minn.-based health system's effort to leverage artificial intelligence to improve healthcare.
"What's most important about the 2020 release is its focus on social determinants of health and other aspects of the total patient experience in healthcare," Halamka said. "As we move from fee-for-service to value-based purchasing and other risk models, it's essential to focus on patient wellness, and not just illness."
Mari Greenberger, senior director of informatics at the Healthcare Information and Management Systems Society, said she was "very excited" to see the additions.
"The fact that (social determinants of health) is being called out, is being acknowledged, I think is a win," she said. There's opportunities to expand those categories in future editions, she added.
As it continues to build out these components, the ONC should work with private-sector groups developing and evaluating standards for data on social determinants, said Ben Moscovitch, project director for health IT at the Pew Charitable Trusts.
Other updates to the ISA included new sections dedicated to sharing information about patient needs during referrals, patient cognitive status and an expansion of the advisory's consumer access section, which now includes resources to help providers with collection and exchange of health outcome data reported by patients.
The ISA, which is designed to be a reference of available standards, isn't binding, though the ONC encourages healthcare stakeholders to use it. It's updated on a rolling basis, with a static reference edition posted online annually.
In total, the ONC said the advisory provides resources to help healthcare organizations meet nearly 200 types of interoperability—what it calls "interoperability needs"—including data-sharing for clinical care, public health and administrative transactions.
It's a "signal to the industry writ large on what data elements to focus on, and whether certain standards are available for those data elements," Moscovitch said of the ISA. "It encourages more consistency."
The ISA is just one of the ONC's ongoing interoperability efforts. The Trusted Exchange Framework and Common Agreement, U.S. Core Data for Interoperability and proposed information-blocking rule—which has yet to be finalized—are other examples of ONC efforts to drive more consistent and standardized data-sharing.
"The ISA is a good first step to serve as a resource," Moscovitch said. But "further action is needed by ONC to capitalize on greater standardization."
