Tuesday, August 31, 2010

The August HIT Standards Committee Meeting

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!


Eric C said...

Hi John,

Curious to know, in your role on the Standards Committee, whether you have any insight into whether interfaces that facilitate exchange will need to be certified to meet meaningful use requirements? This article (http://www.informationweek.com/news/healthcare/EMR/showArticle.jhtml?articleID=227101771) in InfoWeek and the rules from ONC and CMS seem to suggest that interfaces would need to be certified, but that seems like a huge task for hospitals, each of which likely have many interfaces. Does BIDMC have custom-built interfaces for which it plans to seek certification?

Thanks for your help!

Eric C said...

Also, curious to know whether meeting the "structured data" requirement for the problem list objective necessitates using ICD-9 or SNOMED?

Thanks again for your insights!

Mark Metzler said...

Here is a useful new website you might want to consider:

Biomedical Device Integration Tech Corner

"An archive of technical documents, protocols, standards and procedures useful for clinical engineers and IT professionals involved in biomedical device integration and connectivity to electronic medical records (EMR)"