Tuesday, September 21, 2010

The September HIT Standards Committee

by John Halamka, Life as a Healthcare CIO

The September HIT Standards Committee included three major topics, all of which are important for "living the dream" of achieving meaningful use in the real world.

First, Jamie Ferguson and Betsy Humphreys briefed the committee on the recent Vocabulary Task Force Hearings which focused on reducing barriers and creating enablers to accelerate interoperability. One such enabler is creating a "one Stop shopping" resource for downloading the vocabularies and codesets required by the Standards Final Rule. Major themes included from the hearings included:

*Clarity about what is required, of whom, for what intended purpose and future vision is more important than simplicity

*A comprehensive plan does not mean it should be done all it once. Phased implementation of prioritized content sets and maps will ease adoption burdens

*A major issue reported by testifiers were intellectual property barriers to making these tools widely available. For examples, there are mappings that are only available to licensed users of proprietary vocabularies (i.e. RxNorm to First Data Bank mapping) and some code sets are embedded in HL7 and NCPDP standards which are only available via yearly membership in those organizations.

Vocabularies are increasingly important and Betsy Humphreys reported that licensure of UMLS for access to SNOMED-CT and RxNorm has grown tremendously - the final rule has accelerated adoption of controlled terminology. Thus, it is important that resources that facilitate the implementation and maintenance of meaningful use vocabularies are important.

Several ideas for addressing intellectual property issues were discussed including government licensure of vocabularies for general use and centralized procurement/license management for vocabularies needed for meaningful use that reduces the burden on hospitals and eligible professionals.

Judy Murphy and Liz Johnson presented the Implementation Workgroup's key priorities for the next year which include information sharing and communication to reduce the burden of achieving meaningful use. Hospitals and eligible professionals have similar questions, frustrations, and change management challenges. By leveraging the wisdom of the crowd via novel social networking approaches and education, we can accelerate the process for all.

Doug Fridsma presented the Standards and Interoperability Framework, the RFPs that have been awarded, and processes that will be defined to ensure that clear, easy to use implementation guides are available in the future.

Next month we'll hear from the HIT Policy Committee so that we can begin the standards selection effort in support of Meaningful Use Stage 2 and 3. The industry needs a phased implementation plan and thus my preference would be to declare what is needed for stage 3 and then define stage 2 as the incremental steps to get us on the right trajectory.

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