Health Language Blog

New MACRA Measures Sharpen Focus on Semantic Interoperability

Posted on 09/21/16



Healthcare’s interoperability quest continues to mature, moving the industry closer to semantic interoperability—the highest level of information exchange as defined by the Health Information and Management Systems Society (HIMSS). ONC’s recent identification of two metrics to support specific indicators of “widespread interoperability” demonstrate this movement.

Responding to directives laid out by The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), these measures were developed in cooperation with industry stakeholders following a Request for Information and review of more than 100 corresponding comments. They include:

  • Measure #1: Proportion of healthcare providers who are electronically engaging in the following core domains of interoperable exchange of health information: sending, receiving, finding (querying), and integrating information received from outside sources.
  • Measure #2: Proportion of healthcare providers who report using the information they electronically receive from outside providers and sources for clinical decision-making.

The new metrics align with the goals of semantic interoperability, which is characterized by the ability of disparate IT systems to understand and query data, not just view and store it. They also underscore the need for data normalization strategies that lay the groundwork for information sharing that is understandable and meaningful to care delivery.

The reality is that most health systems manage dozens of clinical, claims, and administrative systems—all with their own inherent language. Semantic interoperability demands that all of these varying terminologies and custom or proprietary codes be normalized to an agreed standard accepted by systems communicating with each other. This way, data elements are represented the same way across disparate platforms. When this framework exists, healthcare organizations can address the “integration” needs of MACRA interoperability measure #1 and the goal of “using information for clinical decision-making” found in measure #2.

For many resource-strapped organizations, this strategy begins by leveraging the expertise of an industry partner and an advanced enterprise terminology management platform such as Health Language. By automating standard clinical terminology into healthcare software applications or data warehouses through real-time automapping and integration technologies, data can be safely exchanged and accurately analyzed.

The good news for providers on these newly introduced measures is that they will not require additional reporting. Data will be retrieved from existing national surveys of hospitals and office-based physicians, including the American Hospital Association’s AHA Information Technology Supplement Survey and the Center for Disease Control and Prevention’s (CDC) National Center for Health Statistics annual National Electronic Health Record Survey of office-based physicians.


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Topics: semantic interoperability, MACRA

About the Author

Dr. Brian Levy, MD is Vice President and Chief Medical Officer with Health Language, part of Wolters Kluwer Health. He holds an MD and BS from the University of Michigan. Go Blue!