Please note: This post by the HIT Standards Committee’s Implementation Workgroup is now closed for comment. Monitor this blog for more posts from the FACA committees and its workgroups as issues develop. Also, please visit the Health IT Buzz Blog to join other Health IT related conversations.
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
Hi All,
I’ve used EMR now since 1990. Initially it was with Word Perfect, and since 1995 with MS Word. It works great. It can run off a flash drive from your pocket. You can use it in your hospital, nursing home, office, your HMO or your own home. It gives you flexibility and speed.
Too many restrictions can drag things down.
I expect the primary care physicians in 10-15 yrs to be responsible for compiling a patient’s record each visit into just 2-3 pages. Otherwise, physicians are faced with 10+ thousand screens per patient after a couple of years use.
Cheers … Gil
Gil Carter, MD, JD
60 second peek movies of TSMR in regular use: http://www.TenSecondMedicalRecord.com
Agree or Disagree:
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I think that the HL-7 CCD/CCR standard should be the one and only standard used for HIE. The ARRA/HITECH money should only be used to support this type of HIE. There is a tremendous amount of flexibility built into that standard and new components will be added over time.
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it is amazing that the time and efforts of the many volunteers who created interoperability standards such as CCD and XDS, and the millions of man hours by suppliers to code their products to interoperate according to these standards, is even a question amazes me. While CCR enjoys support from a few very vocal proponets, it is NOT the concensus standard adopted or accepted by HHS. Changing boats mid stream would cost millions and would further delay the meaningful exchange of clinical data, something we as a nation, can not afford to do.
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I’ve tried to read many of the postings on this blog and find that the vast majority are from physicians addressing the challenges of implementing an EMR in the physician office setting. I’d like to weigh in from the community hospital perspective. Since the purpose of this group is to focus on establishing standards and implementing those standards, I’ll try to focus my comments in that direction.
My team recently completed a multi-year implementation of a clinical system which cost millions of dollars and tens of thousands of staff hours. I say multi-year because we started with a selection process in 2003, then started the implementation in earnest in 2004 with an initial live date in 2007. Initial because, as we know, information systems are the ‘gifts that keep on giving’, and we have gone through numerous enhancements and upgrades since our original go-live.
In terms of documentation standards, we chose to utilize the nursing standards of NIC, NOC, and NANDA for our problem lists. The specification of SNOMED or ICD-9 in the current meaningful use draft puts a question mark on this for us. Though there is some linkage between SNOMED and NANDA, my team is now trying to determine what would be needed for us to comply. Every change consumes tremendous staff resources and the uphill struggle required to get culture change and buy-in from users.
Physician offices will clearly struggle with this as well. As an aside, a number of the physician related postings appear to focus on lost productivity. However, there are clear examples of providers who have made productivity strides with EMRs. One reason for the different experiences may tie to a practices’ challenge in successfully changing workflow to extract benefit from the EMR. Perhaps a more concerted effort to communicate best practice standards in this regard may be helpful.
Agree or Disagree:
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12 (+8)