Office of National Coordinator for Health IT Policy and Standards Committees: Response to JASON Report

After the publication of the JASON report, the Policy Committee and the Standards Committee of the Office of National Coordinator for Health Information Technology convened a task force to respond to the report.  In October 2014, this joint task force published its response.  The task force fundamentally agreed with the JASON report that an application program interface (API)-based strategy for interoperability is needed, and that Meaningful Use Stage 3 requirements should have an increased focus on interoperability. However, the task force disagreed with the JASON report about the degree of progress that has currently been made towards interoperability, and highlighted policy, legal, governance, and business issues with adopting an API-based strategy. The task force also noted that the JASON report recommends a top-down regulatory approach (while failing to identify the regulatory authority to mandate such an approach), while the task force still supports a market demand approach (where the current market demand for interoperability is still weak).

The task force made specific recommendations to ONC and CMS to begin to implement a modified API-based strategy, working within existing committees and regulatory processes, including Meaningful Use Stage 3 requirements. The task force described this strategy as “coordinated architecture [i.e., the JASON report’s call for a national API-based strategy] that loosely couples market-based data sharing networks” (i.e, existing health information exchanges).

The specific recommendation that caught the most attention and discussion by the members of ONC Policy and Standards Committee was “the potential need for delay or staggering of MU Stage 3 incentives, to account for the time needed to standardize and then implement the Core Data Services of the Public API.”  After discussion, this wording was amended to recommend that “CMS and ONC should consider mechanisms to accommodate an accelerated process for a feasible initial public API specification.”

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