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Is The ONC Still Relevant?

Posted on July 18, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Today, I read an article in Healthcare IT News reporting on the latest word from the ONC. Apparently, during a recent press call, National Coordinator Donald Rucker, MD, gave an update on agency activities without sharing a single new idea.

Now, if I were the head of the ONC, I might do the same. I’m sure it played well with the wire services and daily newspapers reporters, most of whom don’t dig in to tech issues like interoperability too deeply.

But if I were wiseacre health IT blogger (and I am, of course) I’d react a bit differently. By which I mean that I would wonder aloud, very seriously, if the ONC is even relevant anymore. To be fair, I can’t judge the agency’s current efforts by what it said at a press conference, but I’m not going to ignore what was said, either.

According to HIN, the ONC sees developing a clear definition of interoperability, improving EMR usability and getting a better understanding of information blocking as key objectives.

To address some of these issues, Dr. Rucker apparently suggested that using open APIs, notably RESTful APIs like JSON, would be important to future EMR interoperability efforts. Reportedly, he’s also impressed with the FHIR standard, because it’s a modern API and because large vendors have very get some work with the SMART project.

To put it kindly, I doubt any of this was news to the health IT press.

Now, I’m not saying that Dr. Rucker got anything wrong, exactly. It’s hard to argue that we’re far behind when it comes to EMR usability, embarrassingly so. In fact, if we address that issue many of EMR-related efforts aren’t worth much. That being said, much of the rest strikes me as, well, lacking originality and/or substance.

Addressing interoperability by using open APIs? I’m pretty sure someone the health IT business has thought that through before. If Dr. Rucker knows this, why would he present this as a novel idea (as seems to be the case)? And if he doesn’t, is the agency really that far behind the curve?

Establishing full interoperability with FHIR? Maybe, someday. But at least as of a year ago, FHIR product director Grahame Grieve argued that people are “[making] wildly inflated claims about what is possible, [willfully] misunderstanding the limits of the technology and evangelizing the technology for all sorts of ill-judged applications.”  If Grieve thinks people are exaggerating FHIR’s capabilities, does ONC bring anything useful to the table by endorsing it?

Understanding information blocking?  Well, perhaps, but I think we already know what’s going on. At its core, this is a straightforward business use: EMR vendors and many of their customers have an incentive to make health data sharing tough. Until they have a stronger incentive share data, they won’t play ball voluntarily. And studying a much-studied problem probably won’t help things much.

To be clear, I’m relying on HIN as a source of facts here. Also, I realize that Dr. Rucker may have been simplifying things in an effort to address a general audience.

But if my overall impression is right, the news from this press conference isn’t encouraging. I would have hoped that by 2017, ONC would be advancing the ball further, and telling us something we truly didn’t know already. If it’s not sharing new ideas by this point, what good can it do? Maybe that’s why the rumors of HHS budget cuts could hit ONC really hard.

FHIR is on Fire

Posted on December 5, 2014 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Ever since the announcement yesterday about Project Argonaut, FHIR has been getting some widespread coverage. Although, even before this important announcement, I was hearing a lot of people talk really optimistically about the potential of FHIR for healthcare. However, with Project Argonaut, you get all of these big name organizations on board as well:

  • athenahealth
  • Beth Israel Deaconess Medical Center
  • Cerner
  • Epic
  • Intermountain Healthcare
  • Mayo Clinic
  • McKesson
  • Partners HealthCare System
  • SMART at the Boston Children’s Hospital Informatics Program
  • The Advisory Board Company

That’s quite a list of powerhouses that are investing money behind FHIR. I’m excited that the majority of major hospital EHR are represented in that list. Although, I do wonder if this is a lot of the same people who ruined CCDA. Let’s hope I’m wrong and they learned their lesson.

FHIR was also the topic of today’s #HITsm chat. Here are some of the tweets from the chat that caught my eye.

How’s that for optimism about the future of FHIR? Keith is deep in the trenches of health IT standards so he’s got a very informed opinion on what’s happening.

A very good sign since everyone I talk to seems to hate CCDA. They say that it’s bloated and really not usable.

I agree with Donald. The real question I have is whether FHIR will get us open APIs to the data we want. I need to investigate more to know the answer to that question.

I generally think this is true also, but not if it is a limited set of data. If you limit the data and don’t provide write back function, then there’s a real limit on what you can do with that data. Of course, you can start with some functionality and then build from there.

I’m still early on in my understanding of FHIR. I’m doing a whole series of posts on EMR and HIPAA around interoperability and the challenges associated with interoperability. You can be sure that FHIR will be a major part of my research and discussion. The above links look like a good place to start.

Please add your thoughts on FHIR in the comments as well.