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ASSIGNMENT 1 (1 PAGE) According to HIMSS, interoperability “describes the extent to which systems and devices can exchange data, and interpret that shared data. For two systems to be interoperable, they must be able to exchange data and subsequently present that data such that it can be understood by a user.” There are four levels of interoperability:

1. foundational 2. structural 3. semantic

4. organizational Foundational interoperability: the ability of one I.T. system to send data to another I.T. system. The receiving I.T. system does not necessarily need to be able to interpret the exchanged data — it must simply be able to acknowledge receipt of the data payload. This is the most basic tier of interoperability.

Structural interoperability: “the uniform movement of healthcare data from one system to another such that the clinical or operational purpose and meaning of the data are preserved and unaltered,” HIMSS states. In order to achieve structural interoperability, the recipient system should be able to interpret information at the data field level. This is the intermediate level of interoperability.

Semantic Interoperability: the ability of health I.T. systems to exchange and interpret information — then actively use the information that has been exchanged. Semantic interoperability is the highest level of interoperability.“Semantic interoperability takes advantage of both the structuring of the data exchange and the codification of the data, including vocabulary so that the receiving information technology systems can interpret the data,” stated HIMSS. Achieving semantic interoperability allows providers to exchange patient summary information with other caregivers and authorized parties using different EHR systems to improve care quality, safety, and efficiency. This level of interoperability allows healthcare organizations to seamlessly share patient information to reduce duplicative testing, enable better-informed clinical decision-making, and avoid adverse health events. Effective health data exchange can also help to improve care coordination, reduce hospital readmissions, and ultimately save hospitals money.

“New” Organizational (Level 4) – includes governance, policy, and social. While semantic interoperability is the goal, most healthcare organizations are still working to establish foundational and structural interoperability. Hospitals and health systems can utilize existing health data standards to achieve lower levels of interoperability and set a solid foundation for future improvements in health data exchange. Evaluate one of the Interoperability levels listed above. Include the following aspects in the discussion:

• Using your text and other course resources, assess one of the following levels listed above and its importance in achieving full interoperability.

• Discuss technical and economic barriers hospitals face in achieving your chosen level of interoperability.

• Explore the role the government plays in your chosen level. • Share suggestions as a health care leader to support the development

of your chosen level.

ASSIGNMENT 2 (1 PAGE)

Information blocking poses a threat to the benefits of EHRs and health I.T. The Office of the National Coordinator for Health Information Technology (ONC) describes information blocking as the intentional and unreasonable blocking of health information among health I.T. systems. This practice does not include the blocking of information for health data privacy reasons or because of reasonable barriers. Federal organizations, including The Centers for Medicare & Medicaid Services (CMS) and ONC, have increased pressure on providers and health I.T. companies still engaging in information blocking. In addition to federal policies, incentive programs also underscore the importance of putting an end to information blocking. As part of the Merit- Based Incentive Payment System (MIPS) under the Quality Payment Program (QPP), providers must attest to the prevention of information blocking

reporting requirements. There are several actions ONC and other federal agencies can take to address certain aspects of the information blocking problem. These actions include:

1. Proposing new certification requirements that strengthen surveillance of certified health I.T. capabilities “in the field.”

2. Proposing new transparency obligations for certified health I.T. developers that require disclosure of restrictions, limitations, and additional types of costs associated with certified health I.T. capabilities.

3. Specifying a nationwide governance framework for health information exchange that establishes clear principles about business, technical, and organizational practices related to interoperability and information sharing.

4. Working with the Centers for Medicare & Medicaid Services to coordinate health care payment incentives and leverage other market drivers to reward interoperability and exchange and discourage information blocking.

5. Helping federal and state law enforcement agencies identify and effectively investigate information blocking in cases where such conduct may violate existing federal or state laws.

6. Working in concert with the HHS Office for Civil Rights to improve stakeholder understanding of the HIPAA Privacy and Security standards related to information sharing.

Reflect on ways to prevent Information blocking. Include the following aspects in the discussion:

• Choose one of the actions to address the information blocking problem

• Choose an aspect not already chosen by a peer

• Find two scholarly recent (less than three years) references about your chosen action

• Summarize the action and explain how it can help with solving the issue

• Discuss the reasons why providers and vendors are still engaging in information blocking and the impact on patient outcomes