Wednesday, February 3, 2010

Next Steps for the Implementation Workgroup

All HIT Standards Committee Workgroup meetings are now open to the public so you can listen to the debate as it happens.

Last week, the Implementation Workgroup discussed next steps to empower clinicians, patients, and communities in their quest for meaningful use of healthcare IT.

We discussed topics for public hearings of experts

1. Creation of a Health IT Implementation Starter Kit - How can we learn from best practices in Beacon communities, forward thinking practice groups, and early adopter HIEs?

2. Transmission - How do we solve the transmission problem of sending data securely from provider to provider, provider to payer or provider to population health data aggregator?

3. Engaging Patients and Families - How do we package data for patient engagement? What is included in a summary medical record or encounter summary? How do we transmit the package from providers to patients?

4. Quality measurement - how do we reduce the burden on practices of computing and submitting quality measures?

5. Vocabularies - how do we lessen the burden of ICD10 adoption, how do we provide a free, up to date starter set of controlled vocabularies such as a LOINC lab compendium, SNOMED-CT problem list, and others codesets needed to support meaningful use.

The Workgroup decided to begin with the Implementation Starter Kit and host severals panel in a day of public hearings.

a. Panel on Federal contributions (VA, DoD, ONC role)
b. Consortia – sharing data in a new ways, breaking down silos
c. Exemplars – lessons learned from the field, large and small organizations. What is their approach to meaningful use?

The hearing will be followed up by blog/structured dialog over course of 3-4 weeks.

The first hearing will be in early March after HIMSS.

I look forward to sharing best practices from the trenches. You can always count on my contribution of all BIDMC's experience and IT intellectual property.


Jonathan Krasner said...

Dr. H -- I work at a network design and support vendor for ambulatory groups. I would hope that in the best practices area that you speak about, you will include best practices for network design, implementation and support. Many times practices will look to the EHR vendors for help in this area, but they are more involved with the software than the hardware end of things. A great example is backup and disaster recovery. We still see implementations with tape backups! I would be happy to help if you would like input in this area.

Hans Buitendijk said...

Dr. Halamka:

Thank you for the summary of the meeting that just occurred. We are looking forward to the schedule of the upcoming work group meetings.

Regarding the proposed list, a number of topics (e.g., topics 1, 2 and 3) have the potential to substantially re-trace the progress facilitated to date through HITSP aligning implementation guidance across a wide and large group of stakeholders. We are pleased that Topic #1 will receive your attention first and do support the intent of implementation starter kits. However, every effort should be made to reuse the work that has already been done by SDOs, HITSP, and other HIT SC workgroups, while improving on the process and content gaps, rather than starting from scratch again. The industry needs an orderly, predictable glide path (roadmap) with less twists and turns.

Also, it seems that there are some topics (e.g., topics 2,4,5) where other HIT-SC work groups are also tasked to focus on. We hope that the Implementation Workgroup will focus on implementation (and ease of adoption) issues, rather than on specific standards selection issues, which are the responsibility of those other workgroups.

drscarlat said...


Thanks (again) for sharing your thoughtful and interesting insights on the recently published IFR, among other numerous HIT issues.

I have a simple question:

Have you guys considered on numbering the requirements related to standards, vocabularies, context exchange, etc. in the IFR document so they can be uniquely identified ?
Is this something expected to happen automatically once the IFR is not interim anymore ?

It is easier (not to mention more efficient) to identify the requirement for a certain standard to be implemented say in "Patient Summary" by some UID number than by acronyms or page and paragraph location...

Thanks and keep up the excellent work !
Alex Scarlat MD

Brian Ahier said...

I am so happy that not only are the meetings open to the public, but they have the audio posted for download the next day.
When I can't listen live I can put it on my iPod and listen later when I'm driving or working out. Kudos to the staff at ONC for making such strong efforts at transparency!