Today, the Health IT Standards Committee within the Department of Health and Human Services will begin an unprecedented effort to get the public’s view on how our work might “pull forward” the benefits of healthcare information technology (IT). Specifically, we’re interested in uncovering new strategies to accelerate the adoption of health IT standards. This effort began with the passage of the American Recovery and Reinvestment Act of 2009, calling for recommendations on standards to promote safe, secure, healthcare information exchange.
“Standards” are really the guardians of quality, consistency, and interoperability. Without thoughtful, clear and uniform standards, we cannot enable the seamless and secure exchange of electronic health information (or the benefits that accrue to providers and patients from such protected exchanges).
So, while the exploration of technical standards may seem mundane to some, it is foundational to electronic health records (EHRs) and electronic health information exchange more broadly. In other words, it’s worth paying some attention to, and voicing your opinions.
Our process continues with a public hearing today in Washington, DC, accessible via phone and webcast at http://healthit.hhs.gov/portal/server.pt. We are convening four panels of experts with on-the-ground experience in interoperability standards – providers, quality stakeholders, health IT vendors, and a group with lessons drawn outside of healthcare. Thanks to HIT Standards Committee member Judy Murphy for her leadership on this effort.
The public hearing draws to a close this afternoon but we will continue the conversation through an Online Forum over the next two weeks. Thanks to Committee Member Cris Ross for his leadership on this effort. Given the breadth of interests, we have arranged a series of Committee Member blog posts to begin the dialogue, starting with HIT Standards Committee Vice-Chair John Halamka’s summary of our work to date, which will post on Friday. We will concurrently enable ongoing discussion threads on the following topics:
1) Proposed Standards (General Discussion)
2) Interoperability
3) Vocabularies
4) Privacy
5) Security
6) Quality
7) Implementation Case Studies (Your Story – the good, bad and in-between)
We have also enabled a “voting” feature on submissions to allow you – the public – an opportunity to emphasize points raised in a given post. Our goal is to harness the shared wisdom of our community to inform the work of the HIT Standards Committee in the weeks and months ahead.
The tight schedule of this process is designed to ensure that your ideas inform the HIT Standards Committee at its November 19th meeting. However, your ongoing feedback on our efforts is also encouraged via written submission or public comment at any of the subsequent monthly meetings of the HIT Standards Committee.
The process of accelerating the adoption of health IT standards will not end this week, this month, or this year. This is an ongoing effort, and your participation will continue to be essential to its success.
– Aneesh Chopra, U.S. Chief Technology Officer
Tags: FACA, Federal Advisory Committee Act, health IT, HIT Standards Committee
I have been forced to use various CPOE and EMR equipment. The dangers are extensive and pervasive.
CPOE gear deployed in hospitals has caused mayhem that has resulted in patient death, all the while being blamed on the doctors who were forced to use the equipment.
That the ONC has not condsidered the abject dangers of CPOE devices is despicable and the failure to consider safety and efficacy as a component of meaningful use is folly.
There is dire need for the truth about these dangers to be known. It has been suggested that all users report their experiences in which patients were endangered, injured, or killed to the FDA at ist Medwatch tab.
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We have had EMR for three years and there are occasional problems with it. But our main concern is that if our EMR doesn’t meet the “meaningful use” criteria we are going to have to upgrade to a new system. We are still paying for the old system….can we not wait until we have resolved that expense before we add another huge cost to it. Are you trying to put away all of the smaller practices who can barely survive now? Between Government Mandates and Insurance/Medicaid cuts, smaller practices are not going to be able to continue in business. You probably need to start a committee to head up “government owned healthcare providers” to fill the void.
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I attended the HIT Standards Committee Meeting today with a focus on security.
Most, if not all current HIT software and hardware come with built-in security measures. But, since these are selling features but not the primary medical application, often the product is installed with the default being “off” and the user being unaware of the feature, much less how to activate it, update it, and audit it.
This is like buying a new car with air bags, and after your accident in which they don’t deploy, the car dealer says “Oh, did you want the sensors in your air bag system activated?”
Examples:
1) Many small practices use Peachtree Accounting Software, which is installed with its internal audit trail feature in the default “off” setting.
2) LAN switches and routers that support a firewall and passwords, but which aren’t activated.
3) Clinical diagnostic siloed applications like ECG management systems, ultrasound images storage systems, cath lab hemodynamic systems: although their application software may freceive reqular updates, its uderlying basic operating system may not update its critical patches; or, it may have an internal communication modem which is not protected in the same manner as a seperate LAN modem.
HIPAA Compliance and HITECT Security measures must not just be built-in potential “we meet the regulations” capabilities, but intergal features that are “on” and automatically updated like my PC’s virus protection.
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I have been in private practice for over thirty years and still love clinical practice.
I have a private office and consult in two local hospital stroke and head trauma units, as well as visiting numerous rehabilitation centers.
I use very advace testing and documentation technology. I am neither a techno-phobe or geek. I am a clinician who will pursue any avenue to serve my patients.
I have used IT people to counsel me throough the set up and modification of business management and clinical hardware and their supporting software. To me IT has come to meat I Tried and I Think.
I used many redundant backups for my system. A singl;e event lost 30 % + of my annual billings. Recovery of this data although incomplete required a thorough mining of and reconstructions of billing from physical records.
A paperless office is a witless solution.
Data corruption and loss are part of the definition of any system implemented. Continuity of care? Unlikely if the data is lost. Out come based documentation? Impossible if data is even compromised by entry, recovery or analysis errors.
There are no systems curently available that allow the non-quantifiable observations of the experienced physician to be posted and recovered in a reliable format.
Attempting to quantify the subjective is an oxymoron conceived by either oxes or morons.
I do believe in advancing documentation techniques, but I cower when I conceive of data being easily corrupted or compromised.
No technological defense has a life expectency beyond its implementation date, and mandated and the security required to protect personal health information
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I agree with Mr. Maglothin’s post that physician groups need to understand the big picture when going into automated systems, meaning the investment in time is as important as the financial investment. Physician and administrative leadership is also very important to successfully navigating the change and workflow management needed when implementing a new technologies. Our practice implemented a fully-integrated EHR, practice management and interoperability solution called PrimeSuite by Greenway Medical. Our system has been great. Highly customizable to our primary care workflow and affords us the capability to check patient records securely from out of the office. We appreciate the flexibility and so does our patients. We allow them to access their patient information remotely along with scheduling and prescription requests. There does seem to be a lot of animosity towards EHR companies on this site but if practices and my fellow doctors researched EHRs and looked for the ones being meaningfully-used in their specialty and practice size today, they would be much better off. We should not need the government to dictate this? I do not mind their assistance here but there are many, many success stories out there but unfortunately, most practices and practitioners are busy caring for patients and not blogging. I saw this site and felt compelled to say something as well as share my positive experience. I can offer you a list of 1,500 EHR deployments & sites that are happy and 30,000 users across America. Many or all of us have great ROI, increases in patient satisfaction, standards-based (CCD) interoperability with our community, beginning clinical research straight from our EHR, and all very happily doing this.
I hope this helps. Thanks, Michael A. Poss, M.D., FAAFP
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I totally concur with the CV practice experience in LA. Many EHR vendors are focused on functioality without regard to usability.
Our single specialty cardiology practice(22 physicans) deployed a similar EHR that allowed incremental implementation thus accommodating physician workflow variations. This has allowed greater buy-in so as we have rolled out more complex functions (DSS with alerts and quality reporting) the practice has not experienced disruption.
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In 2008 we replaced our point-and-click system with a hybrid EMR which has been very successful in our practice and embraced and adopted by all providers and staff. We implemented the hybrid EMR throughout our entire organization quickly and easily – it was a very smooth transition. With the new system, we have the full benefits of instant patient chart access, efficiency, and better patient care.
Because of the smooth transition, our employees were much more receptive to the change and our physicians were receptive to viewing patient charts in a 100% digital format.
Overall, the benefits of a hybrid EMR have proven to be:
1. Physicians do not have to change the manner in which they have practiced for years.
2. The organization does not lose revenue due to a decrease in patient visits.
3. Easy “buy-in” from providers and employees.
4. A more efficient practice that is more attentive to patient needs.
5. Higher quality patient care.
Thank You,
Jea’n Oubre LPN
Senior Health Information Specialist
Houma, Louisiana
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