Wednesday, October 1, 2014

The Standards Committee Work Ahead

On October 15, the Policy Committee and Standards Committee will meet to review the draft interoperability roadmap that will guide our work in the post Meaningful Use era.

The draft to be presented is a work in process and will be iteratively improved over the next 4 months with multi-stakeholder input.  Clarifying the Modern Healthcare story, October 15 will include a straw man for Federal Advisory Committee reaction, not a finished plan.

We’ll also hear an important presentation from the JASON task force, translating the general recommendations in the JASON report into actionable policy and technology next steps, especially around the need to extend interoperability from the sending/receiving of CCDA documents to also enable the data-element level query capabilities of well defined, secure application programming interfaces (APIs), likely using HL7’s Fast Healthcare Interoperability Resources (FHIR).

Meaningful Use Stage 3 regulations are currently in draft and will be released as NPRM before the end of the year.    My hope for these regulations is that they will be less prescriptive than previous stages, reducing the burden of implementation for providers and vendors.

It’s purely my opinion, but I’m optimistic that simplification will happen, given that the 2015 Certification Rule is likely to decouple Meaningful Use and certification.  Certification is likely to be incremental year to year without the tidal wave of requirements we’ve seen in the past.  Certification of health IT (not just EHRs) will be with us for a long time and may be leveraged by more programs than just the EHR incentive programs.    Imagine that modules for patient generated data (such as wearables), health information exchange (HISPs), and analytics services (such as those used for care management by ACOs) could be certified and used in any combination to achieve outcomes.

I look forward to a future of FHIR-based APIs with security enforced via OAuth2 and transport facilitated by RESTful approaches as the Meaningful Use program ends and ONC moves forward with its mission to improve quality, safety and efficiency,  using policy and technology levers that enhance interoperability.

1 comment:

William Hersh, MD said...


Do you believe this effort will bring us closer to the informatics "holy grail" of semantic interoperability?

I have always believed (or naively hoped?) that we could put enough semantic interoperability in place in healthcare such that at a high level, we could standardize things like what is a problem, what is a note (e.g., H&P, progress note, discharge summary, etc.), and what are the unambiguous names of things we commonly use (e.g., drug names, lab test names), etc.. I get that we may never be able to standardize the nuances in a clinician's narrative description of a patient, but is it a pipe dream to believe we cannot standardize some of the more common elements of data across all healthcare institutions?

Does the Standards Committee share this view?