Wednesday, July 15, 2009

Dispatch from Washington

Today I was in Washington attending two important meetings - an Institute of Medicine gathering to discuss healthcare information exchange and the HIT Policy Committee Certification/Adoption Workgroup.

The Institute of Medicine meeting brought together 30 experts from computer science, informatics, and the health information exchange community to discuss the applications of grid computing technologies to health information exchange.

I presented an overview of the HIE work in Massachusetts and Indiana using these slides. Ken Buetow from NCI presented an overview of the major concepts from Grid Computing efforts to date.

We discussed the possibility of using Grid Computing methodologies in healthcare clinical care, population health, and research. Here's an overview of the vision (NCHI) presented by Patrick Soon-Shiong and his scientific advisory board chaired by Dr. Ian Foster and Carl Kesselman, two grid computing pioneers. As I next step, I will work with Dr. Kesselman to learn more about the standards and architectures used in Grid Computing to understand how they may help solve some of the challenges facing healthcare stakeholders, especially the research community.

The HIT Policy Committee Certification/Adoption Workgroup is charged with examining the certification and standards harmonization processes, making recommendations for improvements. I presented the latest update from HITSP's Tiger Teams.

Mark Leavitt provided an overview of recent enhancements to the certification process including module certification, self built certification and support for open source initiatives.

Brian Klepper commented on his experiences with certification to date and emphasized the need for independence and multi-stakeholder participation in the certification process.

Steve Waldren commented on the needs of small practioners who need flexibility in the way they deploy EHRs, highlighting the need for an approach to certification which recognizes the variation among different specialties and care settings.

I'll be back in Washington next Tuesday for the HIT Standards Committee presentation of its major deliverables - a matrix which includes all the clinical operations, quality, and privacy/security standards needed to support meaningful use/the ARRA 8 as well as a measure of the deployability of each standard and recommended certification criteria. I'll post all this work on my blog as soon as it is presented at the meeting.


GreenLeaves said...

Grid computing is attractive but does require redundant LAN/WAN connectivity to ensure uptime in the healthcare environment. A friend of mine who is CIO for a match making service felt that the reliability still is a large enough issue for him to shy away for employing this model.

Listening to the speakers in the Policy Committee hearings, I heard repeatedly that the implementation of EHR takes a lot of time. This should provide additional guidance into introducing Meaningful Use in a tiered fashion. Ramping up the anti over time. Early and clear definitions will assist hospital planners to achieve a given level, however a hospital starting EHR now will be hard pressed to be live in 2012 and thus miss some of the ARRA reimbursement.

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