National Academy of Medicine

Procuring Digital Interoperability in Health Care

A Meeting of the Executive Leadership Network for a Continuously Learning Health System, of the NAM Leadership Consortium for a Value & Science-Driven Health System

Meeting focus: Driving healthcare interoperability through collaborative procurement strategies.

Context: Consideration of the NAM Special Publication: “Procuring Interoperability: Achieving high-quality, connected, and patient-centered care through strategic acquisition specifications”

Key discussion questions:

  1. Core elements. What are the core elements of digital interoperability in health and healthcare?
  2. Status and consequences. What is the current status of digital interoperability in HIT and what are the health outcomes and efficiency consequences of the shortfalls?
  3. Approaches and barriers. What are the primary approaches to advancing interoperability at the organizational and system levels, and the primary barriers to success?
  4. Procurement strategy. How have digital procurement strategies worked in other industries, and how can systematic and collaborative strategies by healthcare organizations drive transformative interoperability for the benefit of their patients?
  5. CEO and CIO leadership opportunities. What intra-organizational and system-wide collaborative activities can turn HIT purchasing strategies into a transformative tool for advancing healthcare safety, outcomes, and value?


Meeting Agenda

(please click on links below to view speaker presentations and recordings of each session)

8:30 – 8:45am          Welcome, opening remarks and introductions (listen to an audio recording of this session)

Welcome and call to order
Michael McGinnis, National Academy of Medicine

Opening remarks
Victor Dzau, President, National Academy of Medicine
Harvey Fineberg, President, Gordon & Betty Moore Foundation

Review of the flow of the day
Claire Wang, National Academy of Medicine

Brief remarks from the U.S. Secretary of Veterans Affairs
David Shulkin, Department of Veterans Affairs

8:45 – 10:00am          Interoperability in health and health care: an overview

  • Definitions and care elements of interoperability in health and healthcare
  • Current status of digital interoperability in health
  • Roles and status of standards
  • Existing initiatives promoting interoperability
  • Barriers and rate-limiting factors, including demand- and supply-side forces


Moderator:  Michael McGinnis, National Academy of Medicine

Federal interoperability roadmap and the 21st Century Cures Act (listen to presentation recording)
Don Rucker, Office of the National Coordinator for Health IT, HHS

Leveraging health IT for patient care: practical considerations  (listen to presentation recording)
Christopher Ross, Mayo Clinic

Policy and marketplace drivers for digital interoperability  (listen to presentation recording)
Chantal Worzala,
American Hospital Association

Interoperability: progress, barriers, and key initiatives  (listen to presentation recording)
Micky Tripathi, Massachusetts eHealth Collaborative

Features and status of interoperability in U.S. healthcare  (listen to presentation recording)
Julia Adler-Milstein,
University of California, San Francisco

Open Discussion  (listen to Q&A recording)

10:00 – 10:15am          Break

10:15 – 11:30am          Procuring interoperability: the NAM Special Publication (watch session recording)

  • Background to the project and organization of the activities
  • Current profile of technology procurement in health and healthcare
  • Opportunities and strategies identified in the project
  • Technical components and starting points
  • Interoperability procurement experiences from sectors outside health


Report background, organization and action priorities
Peter Pronovost, Johns Hopkins Medicine

Sezin Palmer, Johns Hopkins University, Applied Physics Laboratory
Meredith Alger, Center for Medical Interoperability
Oscar Marcia,
Eonti Inc.

Bill Johnson, US Navy (former)

Open Discussion

11:30 – 12:45pm          Procuring interoperability: system-wide strategic considerations (watch session recording)

  • System-level view of comprehensive interoperability
  • Technology and infrastructure requirements
  • Platform development approaches: build & license versus open-source
  • Partnerships, consortia, and industry support


Panel discussion, with introductory reflections by each panelist on:

  1. Interoperable health IT infrastructure at points of care: key clinical scenarios
  2. Path towards data liquidity and plug-and-play commercial solutions
  3. Technical infrastructure: common platforms, reference architectures, certification
  4. Standard development and stewardship priorities


Moderator:  Michael Johns, Emory University

Julian Goldman, Partners Healthcare
Laurie McGraw, American Medical Association
Ed Miller, Center for Medical Interoperability
Andy Gettinger, Office of the National Coordinator for Health IT

Open Discussion

12:45 – 1:45pm          Lunch panel: Accelerating marketplace contributions to interoperability (watch session recording)

Panel discussion, with introductory reflections by each panelist on their company and their industry’s contributions to interoperability and what accelerants they recommend.

Moderator:  Wendy Nilsen, National Science Foundation

Bram Stolk, General Electric
David McCallie, Cerner
Rob Klootwyk, Epic
Chuck Martel, Anthem
Eyal Oren, Google

Open Discussion

1:45 – 2:45pm          Procuring interoperability: strategic priorities for healthcare system leaders (watch session recording)

Panel discussion among healthcare organization leaders on the match of the action priorities – Commit, Identify, Collaborate, Specify, and Assess – with their experience, and the most important steps toward implementation.

Moderator:  Karen Guice, Ernst and Young

VADM Raquel Bono, Defense Health Agency, Department of Defense
Jim Jirjis, HCA Healthcare
Charles N. Kahn III, Federation of American Hospitals

Open Discussion

2:45 – 3:00pm          Break

3:00 – 4:20pm          Healthcare CEO Perspectives (watch session recording)

  • Conditions for success
  • Internal leadership opportunities
  • Collaborative leadership opportunities
  • How the NAM might be facilitative


Moderator:  Aneesh Chopra, CareJourney

Reflections and recommendations:
Toby Cosgrove, Cleveland Clinic
Steve Safyer, Montefiore Medicine
Christopher Ross, Mayo Clinic
Stephanie Reel, Johns Hopkins Medicine
Rene Cabral-Daniels, Community Care Network of Virginia

Open Discussion

4:20 – 4:50pm          Immediate priority steps – facilitated discussion (watch session recording)

Moderator:  Peter Pronovost, Johns Hopkins Medicine

Open Discussion

4:50 – 5:00pm          Summary comments, thanks, and adjournment

Peter Pronovost, Johns Hopkins Medicine
Michael McGinnis, National Academy of Medicine

Reception to follow