One more article sayin the same thing
I don't mean any offense here but for goodness sakes I have read this same content dozens of times, different authors. It's not the ONC's fault where they are at as technology developed fast around them and being former developer, I get it with trying to create goals to meet and so on as things change and it's not easy.
I agree on standards as mentioned here and it's a lot of work I agree. The ONC though should drop 10 years off as technology is calling that card as look how much has gone on with just a few short years of meaningful use, it's too far down the road and 3 and 6 are accpetable and 6 will change a lot by the time we get there but a basic skeleton is fine.
Interoperability really should move up to a platform level and take it out of the code other than the stardards that are already here as those help by all means. But when you get past continuity of care things start getting a big confusing. Sure you can maybe use the Blue Button Schema to help out as well.
Current HIE is not sustainable and of course we need to use what's out there and working but these big warehouses of data are going to eat us up. Therefore cloud systems that provide interoperability without the warehouse indeed need a look as that's what we want and the format as not really that imporant as long as you have the exchange and of course the security with meeting all HIPAA standards.
You can look at Zoeticx Clarity server that does this and all EMRs then just need an API to connect, while needed and live the charts integrate, when done connection drops and that's great for security rather than an always live connection. There's many other options to build more apps on the platform as well such as population health and more. Basics apps are there now with both Epic and Allscript APIs already done.
This makes sense to take the interoperability up to a platform where all EMRs including legacy can participate and it will save billions in data warehousing cost and accomplish the mission.