Tuesday, June 30, 2009

Standards Deployability

I've described the taxonomy that we're using in the HIT Standards Committee to characterize "deployability":

Category I- Known/Certain for 2011
Standards are well-accepted and generally seen as deployable

Category II- Known/Certain for 2013
Standards exist, are determined, but are not in the market yet

Category III- Work In Process for 2013 or 2015
Need to converge/refine standards for 2013 or develop for 2015

Category IV- Standards to be determined
“Gleam in the eye,” some concepts exist but no clear path

Providing a measure of vendor, clinician, lab, pharmacy, hospital, and HIE ability to implement standards is just as important as naming the standards to be used in support of meaningful use.

During our recent HIT Standards Committee meeting we discussed other interpretations of deployability including implementation experience to date, known costs of implementation, and trading partner willingness to implement.

Dr. Jim Walker MD, Chief Healthcare Information Officer of Geisinger Health System, summarized the discussion as:

I. Mature – Implemented in 20% (inspired by Gartner's metric that 20% represents a tipping point of acceptance) of relevant healthcare organizations. Implementation methods and costs well specified. Success is dependent on factors external to the implementing organization at most minimally.

II. Ready for Introduction – Widely agreed on and thoroughly tested in detail. Implementation methods and costs are variable and difficult to predict. Ready for widespread implementation in production health IT. Success is largely dependent on internal factors.

III. Well Developed – Widely agreed in concept. Needs detailed specification and testing. Implementation methods and costs are largely unknown. Success is largely dependent on factors external to the implementing organization.

IV. In Development

Over the next month, the HIT Standards Committee will ensure that the concept of deployability accompanies each standard in the meaningful use matrix. This consensus assessment will enable the HIT Policy Committee, ONC, and HHS to make the final decision on meaningful use implementation phasing after weighing the impact of deployability Although it is likely that 2011 meaningful use criteria will be Category I's, there may be a few Category II's if the value/impact of early implementation justifies the effort.

As David Blumenthal said at last HIT Standards Committee meeting, stimulus dollars and the urgency to change may accelerate the ability of all stakeholders to deploy health information exchange and we should not set the bar too low.

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