Tuesday, August 31, 2010

The August HIT Standards Committee Meeting

by John Halamka, Life as a Healthcare CIO

The agenda began with comments from Jon Perlin and me reflecting on the busy Summer, reacting to the final rules, and planning for the future of policies and technologies to support interoperability. I summarized my experience with questions and feedback on the Standards Final Rule. Thus far, questions about consistency of content, vocabulary, and standards named in quality measures have been clarified without requiring changes in the rule.

Sam Karp and Aneesh Chopra summarized the Enrollment Workgroup deliverables that satisfy the requirements of Section 1561 of Affordable Care Act. The recommend use of the NIEM framework to support standards and processes going forward. They recommend the creation of web services on top of existing legacy systems as well as create a reference implementation of running software that could be used by states and other stakeholders (note, this does not imply creating a single Federal hub for all transactions). They recommended use of the HIPAA Content standards (834, 270, 271) and codification of human readable business rules using tools such as OMG’s SBVR. Finally, they made a number of privacy/security recommendations that highlight consumer access to data and disclosure logging.

Deven McGraw and Paul Egerman summarized the Privacy & Security Tiger Team Recommendations. Most important are the consent recommendations that require the patient be provided with an opportunity to give meaningful consent before the provider releases control over exchange decisions. The trigger is when the decision to disclose or exchange the patient’s identifiable health information from the provider’s record is not in the control of the provider or that provider’s organized health care arrangement (“OHCA”), patients should be able to exercise meaningful consent to their participation.

Doug Fridsma provided an overview of Standards and Interoperability Framework and its associated RFPs.

The awardees thus far are:
Harmonization of Core Concepts (NIEM Framework) - Deloitte
Implementation Specifications - Deloitte
Pilot Demonstration Projects - Lockheed
Reference Implementation - Lockheed
Testing - Stanley
Tools and Services - Stanley

The role of the HIT Standards Committee will be to provide oversight, coordination and prioritization advice on the Standards and Interoperability Framework to ONC.

Jamie Ferguson presented the Vocabulary Task Force Update.
Judy Murphy and Liz Johnson presented the Implementation Workgroup Update.
The work ahead in September is defining the Standards requirements for Meaningful use Stage 2 and 3. It will be a busy Fall!

Monday, August 30, 2010

CCHIT and Drummond - Certifying bodies for EHR's

HHS announced today that the following organizations have been selected as ONC-Authorized Testing and Certification Bodies (ATCBs):
According to HHS, certification by an ATCB signifies "to eligible professionals, hospitals, and critical access hospitals that an EHR technology has the capabilities necessary to support their efforts to meet the goals and objectives of meaningful use".

Tuesday, August 24, 2010

CHIME publishes CIO's guide to EHR implementations

The College of Healthcare Management Executives (CHIME) has published a terrific guide to EHR implementations.  The CIO's Guide to Implementing EHR's in the HITECH Era was prepared and reviewed by some of the best in the industry.

Sunday, August 22, 2010

NIST Issues Finalized Test Procedures

NIST has released the approved testing procedures for evaluating EHRs and EHR modules to the standards, implementation specs and certification criteria for ONC's Temporary Certification Program.  These procedures will be used by federally authorized testing and certification bodies (ATCB's) who will be announced within the coming month.

From the NIST web site:
Criteria #Certification CriteriaTest MethodDate Published
§170.302 (a)Drug-drug, drug-allergy interaction checksPDF Icon08/13/2010
§170.302 (b)Drug formulary checksPDF Icon08/13/2010
§170.302 (c)Maintain up-to-date problem listPDF Icon08/13/2010
§170.302 (d)Maintain active medication listPDF Icon08/13/2010
§170.302 (e)Maintain active medication allergy listPDF Icon08/13/2010
§170.302 (f)(1)Vital signsPDF Icon08/13/2010
§170.302 (f)(2)Body mass indexPDF Icon08/13/2010
§170.302 (f)(3)Plot and display growth chartsPDF Icon08/13/2010
§170.302 (g)Smoking statusPDF Icon08/13/2010
§170.302 (h)Incorporate lab resultsPDF Icon08/13/2010
§170.302 (i)Generate patient listsPDF Icon08/13/2010
§170.302 (j)Medication reconciliationPDF Icon08/13/2010
§170.302 (k)Submission to immunization registriesPDF Icon08/13/2010
§170.302 (l)Public health surveillancePDF Icon08/13/2010
§170.302 (m)Patient specific education resourcesPDF Icon08/13/2010
§170.302 (n)Automate measure calculationPDF Icon08/13/2010
§170.302 (o)Access controlPDF Icon08/13/2010
§170.302 (p)Emergency accessPDF Icon08/13/2010
§170.302 (q)Automatic log-offPDF Icon08/13/2010
§170.302 (r)Audit logPDF Icon08/13/2010
§170.302 (s)IntegrityPDF Icon08/13/2010
§170.302 (t)AuthenticationPDF Icon08/13/2010
§170.302 (u)General encryptionPDF Icon08/13/2010
§170.302 (v)Encryption when exchanging electronic health informationPDF Icon08/13/2010
§170.302 (w)Accounting of disclosures (optional)PDF Icon08/13/2010
§170.304 (a)Computerized provider order entryPDF Icon08/13/2010
§170.304 (b)Electronic prescribingPDF Icon08/13/2010
§170.304 (c)Record demographicsPDF Icon08/13/2010
§170.304 (d)Patient remindersPDF Icon08/13/2010
§170.304 (e)Clinical decision supportPDF Icon08/13/2010
§170.304 (f)Electronic copy of health informationPDF Icon08/13/2010
§170.304 (g)Timely accessPDF Icon08/13/2010
§170.304 (h)Clinical summariesPDF Icon08/13/2010
§170.304 (i)Exchange clinical information and patient summary recordPDF Icon08/13/2010
§170.304 (j)Calculate and submit clinical quality measuresPDF Icon08/13/2010
§170.306 (a)Computerized provider order entryPDF Icon08/13/2010
§170.306 (b)Record demographicsPDF Icon08/13/2010
§170.306 (c)Clinical decision supportPDF Icon08/13/2010
§170.306 (d)(1)Electronic copy of health informationPDF Icon08/13/2010
§170.306 (d)(2)Electronic copy of health information
Note: For discharge summary
PDF Icon08/13/2010
§170.306 (e)Electronic copy of discharge informationPDF Icon08/13/2010
§170.306 (f)Exchange clinical information and patient summary recordPDF Icon08/13/2010
§170.306 (g)Reportable lab resultsPDF Icon08/13/2010
§170.306 (h)Advanced directivesPDF Icon08/13/2010
§170.306 (i)Calculate and submit clinical quality measuresPDF Icon08/13/2010