Wednesday, July 8, 2009

It's the Era of ARRA

Today at the HITSP Panel meeting, we approved the work our Tiger Teams completed over the past 60 days to support ARRA:

*EHR-Centric Interoperability Specification

*Exchange Architecture & Harmonization Framework Technical Note

*Data Architecture Technical Note

*Access Control Service Collaboration

*Security Audit Service Collaboration

*Patient Identification Management Service Collaboration

*Knowledge and Vocabulary Service Collaboration

*Healthcare Document Management Service Collaboration

*Query for Existing Data Service Collaboration

*Administrative Transport to Health Plan Service Collaboration

*HL7 Messaging Service Collaboration

*Emergency Message Distribution Service Collaboration

What is a Capability?

A HITSP capability is an implementable business service that specifies interoperable information exchanges using HITSP constructs. It supports stakeholder requirements and as part of its design, it includes information content, infrastructure, security and privacy. Capabilities have options- subsets of the data content can be sent or received as appropriate by a system implementing a capability.

What is a Service Collaboration?

A service collaboration describes the orchestration of data flow such as publish/subscribe, query/response, patient identification, and audit trail creation.

This work is a great simplification of prior HITSP efforts, but there is still work to do.

We will continue to work on our Electronic Publishing framework so that these capabilities are more easily accessible to vendors, HIEs, and other interoperability stakeholders. It will also make them easier to maintain.

The Capabilities point to components, transactions, transaction packages, and base standards. Since SDOs license their content, we cannot include the Standards Development Organization implementation guides. We provide pointers to SDO work products and state the constraints that clarify the details needed to streamline interoperability. In the future, we'll provide additional constraints and work with SDOs to make the implementation guidance available electronically as simple as possible.

What about the future?

It is likely that additional work on standards will be needed to meet all the objectives and metrics of meaningful use for 2013 and 2015.

HITSP will work to address those gaps. HITSP Program Management will leverage the successes of the Tiger Teams and ensure our team structure and processes are optimized to support the HIT Policy and Standards Committees.

We'll also finish work already in process such as Remote Monitoring, Quality, and Clinical Research.

On July 16, the HIT Policy Committee will present the next revision of meaningful use.

On July 21, the HIT Standards Committee will present the standards and certification criteria that support meaningful use, incorporating HITSP work.

We're moving very fast, but we're doing it very openly and by consensus. My thanks to the hundreds of people and thousands of volunteer hours that resulted in the HITSP capabilities and service collaborations that were approved today.


James said...

John - I apologize if this question has already been posed previously - how will the work HITSP is establishing with the standards recommendations, impact currently CCHIT certified EHRs? Will acceptance of the HITSP recommendations force CCHIT to implement (adopt) new criteria and likewise force some current CCHIT certified platforms to retool their product to maintain CCHIT certification?

Thanks for all the great work your doing.

Anonymous said...

Has the bar changed with respect to physicians being qualified for ARRA funds in that I was of the opinion that the rules were EITHER >=30% of patient census (by doc) to be Medicare OR >= 30% of patient census (by doc) to be Medicaid reimbursements?

Is this on a census basis or a $ basis?

Most of us in Oregon have a very hard time meeting those figures. We have given up Medicare patients as we have one of the lowest reimbursement rates in the nation.

your comments on this would be most welcomed.

John Halamka said...

Answers to these questions

1. CCHIT Certification is loosely coupled to HITSP work products. This means that CCHIT will consider all the HITSP work and via our joint workgroup establish certification timelines, but there is no immediate impact on CCHIt certified systems.

2. Medicaid stimulus funds of $64,000 per clinician are available per ARRA for practices with 30% or greater Medicaid patients.