We are pleased to announce that on March 8th, the Implementation Workgroup of the Health IT Standards Committee will hold a public hearing on “Implementation Starter Kit: Lessons and Resources to Accelerate Adoption” to help providers achieve meaningful use by, in part, surfacing examples of effective meaningful use implementation preparation.
As background, the Standards and Certification Interim Final Rule (IFR) was released on December 31st, 2009, along with a Notice of Proposed Rulemaking on Meaningful Use. You can find both of these documents, and other useful information about the rules, here: http://healthit.hhs.gov/standardsandcertification.
To prepare for the March 8th hearing, we are asking you to post questions and comments about implementation opportunities and challenges you are facing today and for which you would either like to share or would welcome support. We want the hearings to be directly relevant to your needs and to learn from the panelists how we might better serve the industry as we prepare for the Committee’s work.
We also are looking for success stories. Some organizations have been engaging in “meaningful use” for some time, and while the IFR is new, the standards embedded in it are not. If you have implementation success stories where you have found innovative ways to address the requirements, we want to know about them, especially if you think they could be useful to others.
Please submit your comment or question about the IFR below. Your comments and questions will help form the agenda for the on-going work of the Implementation Workgroup. In particular, we will use your questions to help generate our agenda for March 8, and we will ask our expert panels to comment on as many of your issues as possible.
We also want to be clear that comments on this blog are not a substitute for official feedback on the regulations. We urge interested parties to also submit comments on the regulations, and the appropriate place to do that is on the Regulations.gov website before March 15, 2010.
Although any comment or question is welcome, we are particularly interested in questions or comments about the four categories of standards:
- Vocabulary Standards (i.e., standardized nomenclatures and code sets used to describe clinical problems and procedures, medications, labs and allergies);
- Content Exchange Standards (i.e., standards used to share clinical information such as clinical summaries, prescriptions, and structured electronic documents);
- Transport Standards (i.e., standards used to establish a common, predictable, secure communication protocol between systems); and
- Privacy and Security Standards (e.g., authentication, access control, transmission security) which relate to and span across all of the other types of standards.
We expect this blog to continue beyond the comment period on the Interim Final Rule. The next phase of work for the Implementation Workgroup will be to provide useful guidance and patterns for implementation of the 2011 standards, and to receive input relating to the 2013 standards that are yet to be fully defined. This Workgroup’s particular emphasis is on facilitating effective and efficient implementation of meaningful use standards, and we hope this forum and our other public activities will be a place where success stories are highlighted, resources are shared, and problems avoided. Your active participation is an important component to our mutual success in achieving meaningful use.
Thank you for your contribution!
– Aneesh Chopra, Chair, Implementation Workgroup
Tags: FACA
We need to look at he complete Health Care supply chain, on a life-time, and life cycle view to see what the process/work-flows should be. Benchmark them, and standardize them to a few “Best Practices”. These best practices can form the basis of a future software, and standards, CCHIT etc. Then choosing the software/package, becomes easier, as you have to see the work-flows for which it has been designed (or to which it can be configured/modified easily), Also an assessment should be made if the new (To-be ) process required is really needed. or is it a hang-over of past practices. Work-flow is best assessed by non-IT folks though.
-Erlend
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There are software companies that can both upgrade and teach effective, intuitive medical software programs that consolidate medical charts and improve the quality of care one receives. I had the opportunity to work with one such company while at UW Madison. Granted, there is a learning curve associated with a program, and it can initially slow down care. Thus far it has been worth it.
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Being a foreigner living in the States I may see things from a little bit different perspective.
How about computerizing only data that is both pertinent to patient care and easily captured, codified and standardized.
Also on the topic of compatiblity, without developing standards for interoperability in advance, we are going to end up with a lot of clunky EMR systems that can’t communicate with each other.
We need free and open standards to be established (and meaningful use defined) before EMR systems are expanded. We need smart people to play a role in guiding national HIT implementation (instead of people who don’t know what interoperability means). We need designers and usability experts who can work with the IT people, systems engineers, clinicians, and patients to develop systems that aren’t clunky and unusable.
Erlend
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As a professional working with a chronic disease, I am most concerned about medical privacy, or lack there of, with any information shared between software systems. As we develop new systems for the implementation of health care please be aware of these issues
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Having worked in the IT industry for more that 25 years, including medical related software, I know that standardization is critical to achieving the end goal. There will also be a certain amount of resistance, as many employees are comfortable with current systems and find the prospect of having to learn new layouts and procedures rather daunting. However, once they are accustomed to the changes, most people accept that improvements have been made and start offering additional suggestions for more improvement.
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There are software companies that can both upgrade and teach effective, intuitive medical software programs that consolidate medical charts and improve the quality of care one receives. I had the opportunity to work with one such company while at UW Madison. Granted, there is a learning curve associated with a program, and it can initially slow down care. Thus far it has been worth it.
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It’s an interesting project and unfortunately a great diversion from my normal work these days, but your request for thoughts on the standards was a little too tempting to miss! OK, my points are shortened deliberately, but are as follows:
1.) The project will require diversion of both funds and resources from other healthcare services. To have wide support for the implementation you will need to show that there is wide support for an integrated system from front-line health practitioners. Both in my post-graduate studies and professional work I have all too often seen that such systems are instigated not because of clinical need or demand from practitioners but because there is a political, fiscal or commercial pressure being improperly exerted. That can mean a failure right from the start.
2.) In developing your Standards there will no doubt be agreement phases in each of the four key areas, include that within your planning. How many revisions or how many depths or levels of understanding do you intend to follow. These will be more important in your vocabulary and content exchange standards formation. Equally important as part of that planning, recognise that it is unlikely in developing medical sciences that you will cover all diagnoses, treatments, etc. nor will you cover every occurrence or similar occurrence across different medical specialisms. You will have a need to build in both redundancies and ongoing terminology developmental systems across the system as a part of the system and then be able to have a system to integrate those developments.
3.) Give significant weighting to other similar projects around the world that have both succeeded and failed. They may not all have worked but knowing what did work, what didn’t work and especially the detail of why is highly significant!
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We need an easy way to identify that the patient is the patient (unique ID or some national matching algorithm). Without a national solution, each region will have their own method that must be replicated and will waste dollar. In addition to wasting dollars the quality may not be the same so people will begin to not trust the sharing of the data if it makes mistakes.
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I spent a lot of years in the computer industry as a Systems Architect. One of the things that never ceases to amaze me is how much the health industry in general will over complicate something quite simple.
As an example, you are looking for input on “transport standards”.
Network transport is something that is readily understood. At most you might want to specify SSL as a transport standard when data is being sent across any public network (e.g. the internet).
Otherwise, network transport, across an IP or IPv6 network is clearly understood, standardized, and documented. Why try to reinvent the wheel here?
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There are software companies that can both upgrade and teach effective, intuitive medical software programs that consolidate medical charts and improve the quality of care one receives. I had the opportunity to work with one such company while at UW Madison. Granted, there is a learning curve associated with a program, and it can initially slow down care. Thus far it has been worth it.
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