New Healthcare Data Standards for the Country

Over the past 2 years, I've had the priviledge of working with 350 organizations as part of the US national effort to standardize healthcare data, supporting the secure exchange of healthcare records among patients, providers and payers with patient consent. On Thursday, December 13, the Healthcare Information Technology Standards Panel (HITSP), completed its 2007 work and approved 4 new "interoperability specifications"

Quality - all the initial standards needed to support the process and outcome measures for the Institute of Medicine's highest priority diseases.

Consumer Empowerment - all the initial standards needed to support personal health records exchanged via networks or via removable media (such as thumb drives). These standards make products like Microsoft Health Vault, the upcoming Google Health, Dossia, Medem, and Relay Health much more useful for patients, as they make the patient the stewards of their own data.

Lab - all the initial standards to order and result laboratories including a consistent description of lab types, reasons for ordering and units of measure. Today, the thousands of labs throughout the US use a heterogeneous collection of standards which require custom programming/configuration to connect them with electronic health records and public health reporting systems.

Emergency Responder - all the initial standards needed to support transfer of information among hospitals and emergency first responders such as paramedics when delivering care in the field, such as might occur in a Katrina-like event.

Also on December 13, the panel approved a Privacy Framework which provides a mechanism to categorize all the various privacy policies that exist in this country. This is important, since security technology to protect confidentiality can only be implemented by first understanding the policies which need to be enforced.

What are the next steps? All of the work done by HITSP on consumer empowerment, labs and biosurveillance will be "recognized" by HHS Secretary Michael Leavitt this month, except for the HL7 2.5.1 message (used to communicate lab results) and the OASIS HAVE standards (used to report hospital resources) which will be recognized in June 2008. Recognition means that federal procurement will require these standards to be included in systems deployed for federal government use. Also, these standards will be included in the Certification Commission for Healthcare Information Technology in 2008 and 2009, encouraging vendors to incorporate them into electronic health records, personal health records and hospital information systems.

As more and more clinicians use electronic health records and interoperability standards become more common, care will become more coordinated, improving quality and reducing costs. Standardization also lays the foundation for patients to be move involved with their care by getting access to all their healthcare data.

Creating a secure, interconnected healthcare system is a journey, but the completion of these healthcare standards for the country is a major first step down that path.