NORC’s 2020 environmental scan follows up on a first of its kind National Survey on Health Information Exchange (HIE) in Clinical Laboratories that NORC conducted for the Office of the National Coordinator (ONC) in 2012, as part of the evaluation of the State HIE Cooperative Agreement Program. The goal of the flagship survey was to assess exchange capability and actual volume of electronic exchange of test results with clinicians and hospitals participating in the Centers for Medicare & Medicaid Services (CMS) Electronic Health Records (EHR) Incentive Programs. Multiple technical and policy developments since the 2012 survey have shifted the interoperability landscape. Notably, new standards of interoperability for data exchange and terminology have emerged and gained acceptance, although challenges with the use of specific standards and interoperability remain.
Given that there has not been a national assessment of interoperability of clinical laboratories since the 2012 ONC survey, NORC was contracted to understand how electronic exchange of laboratory data has evolved since 2012, with an emphasis on the use of standards (i.e., vocabulary and messaging standards) and challenges experienced. Due to the current public health emergency, ONC was also interested in understanding how information is flowing through the public health system (i.e., potentially from hospital and commercial laboratories to public health departments), as well as the electronic capability of public health laboratories and agencies to exchange information on reportable diseases and conditions.
The final report summarized our assessment of the interoperability landscape for ONC leadership and staff, as well as their relevant partners, defined new areas of focus for a survey refresh, and provided recommendations on the content and methodology that should be retained for the next iteration of the survey.