ONC unveils another step toward a Health Internet

Step by step, the Office of the National Coordinator (ONC) for health IT has been opening the door and embracing modern technologies, as it tries to knit together a network of interconnected Electronic Health Records (EHR) systems.

The most recent step in this direction was the unveiling on February 26th of a free, open-source tool called “popHealth” which can be used by healthcare providers and EHR vendors to pull clinical data from their own systems and do their own population care analysis.

The goal of popHealth is to simplify the reporting of summary quality measures and streamline the exchange of such data. One of the measures of Meaningful Use requires the reporting of quality measures and public health data – this tool is designed to help providers submit such data as part of their existing workflow.

Of note, this new prototype tool uses established standards, and is web-based. For web-based EHR vendors, incorporating such a tool is relatively straightforward and can be rolled into a combined offering to physician end-users. For more legacy EHR software vendors, this tool may need to sit side-by-side with their non-web-based user interfaces, but it should still piggy-back onto legacy systems (though it may require the help of IT support staff or consultants to get it all hooked up right).

Taking a step back, the release of such a web-based, open-source solution by the ONC represents a trend that is quite heartening. Traditionally, the ONC has supported the build-out of the Nationwide Health Information Network (NHIN), which is a “network of networks” comprised of multiple local and regional Health Information Exchanges (HIEs). HIEs have been traditionally supported by legacy EHR vendors, and upload of data to them has been difficult to implement – the result has been that large sums of money have been spent on creating and supporting these regional databases, yet to date no “galloping herds” of local physicians have been uploading their EHR data to them.

At the same time, the ONC has begun to embrace the concept of the “Health Internet” – a more consumer-focused platform comprised of discrete, substitutable, modular applications, rather than the traditional HIE approach of massive, consolidated (and somewhat proprietary) networks. The Health Internet is web-based. It is also more market-driven, develops rapidly, and looks to the ONC mainly for standards definition rather than for subsidy.

The release of a web-based, open source tool by the ONC to assist in quality metric reporting is another step towards embracing a “Health Internet” approach. It is a step toward the goal of an interconnected, coordinated electronic health infrastructure that can support the development of a transformed health delivery system. Plug-and-play, modular, web-based pieces of health IT will likely be more successful in achieving this goal than will build-out of increasingly massive, and increasingly expensive legacy systems and networks. We applaud the ONC in this step forward.


Robert Rowley, MD
Chief Medical Officer, Practice Fusion, Inc.