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Nation’s clinical informatics professionals highlight patient-generated health data, a need for infrastructure and governance frameworks for interoperability

In comments submitted last week to the National Science Foundation’s (NSF) Networking and Information Technology Research and Development Program (NITRD), the American Medical Informatics Association (AMIA) supported their future vision for interoperability among medical devices, electronic health records, and other systems within the healthcare ecosystem. In doing so, AMIA observed that the future of interoperability will undoubtedly include data from remote monitoring devices and other kinds of patient-generated health data (PGHD), as well as data from community sources outside the bounds of traditional care institutions.

Last month, NITRD issued a Request for Information (RFI) to determine whether a vision of sustained interoperability in the hospital and into the community is feasible and, if so, what it will take to realize it. The RFI also included a short vignette describing an idealized state of healthcare environment where “people with serious injuries or illness are hospitalized [and] medical device additions and changes are automatically recorded with no deficit in patient safety, loss in data fidelity, or data security as the patient transitions across the continuum of care.” NITRD anticipates hosting a conference this summer to gather further feedback on this topic.

AMIA supported the “Future Vision” articulated in the RFI, but it noted the omission of patient-generated health data (PGHD) and data generated from outside of traditional care spaces. It also urged NITRD to view “interoperability” not as a solution to be obtained or a final destination, but as an ongoing process only achieved through coordinated efforts across stakeholders. AMIA presented its “Socio-Technical Interoperability Stack” to describe the multiple and multi-faceted reasons why information systems may not interoperate.

“There’s no silver bullet in addressing health system interoperability,” said AMIA President and CEO Douglas B. Fridsma, MD, PhD, FACP, FACMI. “We encourage policymakers to think about frameworks for interoperability, not solutions.”

Finally, AMIA made several recommendations in response to specific questions in the RFI. These recommendations included the creation of an infrastructure and governance framework to address issues between medical devices, data, and platforms, as well as suggestions for the diverse stakeholders that must be engaged in such an effort. AMIA cautioned that while NITRD’s Future Vision is achievable, there are several inherent complexities with regard to both standards and the generation, transmission, and use of PGHD. “[T]he interactions envisioned by this future vignette will require great effort and coordination to be realized,” AMIA wrote.

Click here for AMIA’s full response to the RFI.


AMIA, the leading professional association for informatics professionals, is the center of action for 5,600 informatics professionals from more than 65 countries. As the voice of the nation’s top biomedical and health informatics professionals, AMIA and its members play a leading role in assessing the effect of health innovations on health policy, and advancing the field of informatics. AMIA actively supports five domains in informatics: translational bioinformatics, clinical research informatics, clinical informatics, consumer health informatics, and public health informatics.