I've often posted about transport standards and the need to accelerate interoperability by mandating a method for EHRs to send/receive data from each other.
The Meaningful Use Stage 2 NPRM includes such a requirement for transport standards, making healthcare information exchange real. Here's a capsule summary of what it says:
The NPRM proposes that EHR technology be required to implement the Direct specifications - §170.202(a)(1) Applicability Statement for Secure Health Transport - SMTP/SMIME and §170.202(a)(2) XDR/XDM for Direct Messaging. Products cannot be certified unless they support these transport standards.
Transport is also referenced in the Transitions of Care Meaningful Use objective. To support this objective, ONC’s 2014 Edition standards and certification criteria proposed rule includes a certification criterion at § 170.314(b)(2) which would require EHR technology to be certified to the Direct specifications (mentioned above). However, for this certification criterion, EHR technology is also able to be certified to the standard proposed for adoption at §170.202(a)(3) “SOAP-based Secure Transport Requirements Traceability Matrix 1.0” in order to accomplish the cross organizational transport among different vendor applications proposed by CMS as part of Stage 2.
As new transport implementation guides, such as REST, become available, ONC will consider adding them as transport options. The Direct specification certification will be required but others will be listed as viable optional alternatives.
Just as CCR and CCD were offered in Stage 1, then reduced to a single standard in Stage 2, Consolidated CDA, I believe that by Stage 3 a single transport standard will be chosen by the community as the harmonized approach for healthcare information exchange.
With Stage 2, we finally have a parsimonious set of required transport options that will break down data silos in healthcare. That's cool!