Tuesday, September 21, 2010

The September HIT Standards Committee

The September HIT Standards Committee included three major topics, all of which are important for "living the dream" of achieving meaningful use in the real world.

First, Jamie Ferguson and Betsy Humphreys briefed the committee on the recent Vocabulary Task Force Hearings which focused on reducing barriers and creating enablers to accelerate interoperability. One such enabler is creating a "one stop shopping" resource for downloading the vocabularies and codesets required by the Standards Final Rule. Major themes from the hearings were:

*Clarity about what is required, of whom, for what intended purpose and future vision is more important than simplicity

*A comprehensive plan does not mean it should be done all it once. Phased implementation of prioritized content sets and maps will ease adoption burdens

*A major issue reported by testifiers was intellectual property barriers to making code sets and value sets widely available. For examples, there are mappings that are only available to licensed users of proprietary vocabularies (i.e. RxNorm to First Data Bank mapping) and some code sets are embedded in HL7 and NCPDP standards which are only available via yearly membership in those organizations.

Vocabularies are increasingly important and Betsy Humphreys reported that licensure of UMLS for access to SNOMED-CT and RxNorm has grown tremendously. The final rule has accelerated adoption of controlled terminology. Thus, it is important that resources which facilitate the implementation and maintenance of meaningful use vocabularies are made widely available.

Several ideas for addressing intellectual property issues were discussed including government licensure of vocabularies for general use and centralized procurement/license management for vocabularies needed for meaningful use that reduces the burden on hospitals and eligible professionals.

Judy Murphy and Liz Johnson presented the Implementation Workgroup's key priorities for the next year which include information sharing and communication to reduce the burden of achieving meaningful use. Hospitals and eligible professionals have similar questions, frustrations, and change management challenges. By leveraging the wisdom of the crowd via novel social networking approaches and education, we can accelerate the process for all.

Doug Fridsma presented the Standards and Interoperability Framework, the RFPs that have been awarded, and processes that will be defined to ensure that clear, easy to use implementation guides are available in the future.

Next month we'll hear from the HIT Policy Committee so that we can begin the standards selection effort in support of Meaningful Use Stage 2 and 3. The industry needs a phased implementation plan and thus my preference would be to declare what is needed for stage 3 and then define stage 2 as the incremental steps to get us on the right trajectory.


Ahier said...

Great meeting - and then like a speeding bullet over to Capitol Hill to get the SafeRx Award on behalf of Massachusetts! Congrats :-)


David said...

"The industry needs a phased implementation plan and thus my preference would be to declare what is needed for stage 3 and then define stage 2 as the incremental steps to get us on the right trajectory."

Hear hear! Sounds like the excellent concept of the "glide path" which the HIT SC proposed about a year ago. I understand the need to not "lock everything in" too rigidly, and to make mid-course adjustments based on how adoption unfolds in Stage 1 (information that is simply not available yet). Still, especially for areas where criteria have already been established (e.g., exchange key clinical information, CPOE), and where specifications exist (e.g., C32/C83/C80), the glide path concept works quite well to ratchet up the level of content and vocabulary.

Thanks for your update.


Anonymous said...

"A major issue reported by testifiers was intellectual property barriers to making code sets and value sets widely available."

It's a barrier to get the ones free of IP issues as well. If you find an ICD-10-CM file that is machine loadable and not print image PDF it would be a great benefit to software developers if you'd post the URL.

Tom Callahan said...

My gut reaction to your blog entry was a feeling of optimism that it will someday be possible to “live the dream” of achieving Meaningful Use. The approach and high-level objectives of each of the sub-committees appear to be logical and methodical. The end-result of the committees’ efforts to provide standardization and interoperability in healthcare will greatly benefit the U.S. healthcare industry in its efforts to improve both the quality of care and the efficiency, in which it’s provided.

As a Healthcare Product Manager for a Business Intelligence firm, I am responsible for developing the strategy and marketing efforts for our tools that can be used to meet some of the Meaningful Use requirements. Nevertheless, I have been engrossed and overwhelmed by the amount of information that is available via social networking channels, websites, webinars, conferences, events, etc. Thus, I am probably a contrarian, but I am wondering if your quote (last sentence in the 3rd paragraph from the bottom) about leveraging social networking actually is the best idea for accelerating the process for achieving Meaningful Use. The reason for my concern is that information shared via social networking channels is sometimes inaccurate, incomplete, or lacks the proper amount of detail. I have sometimes found myself digging out of the “weeds” or more confused than when I started.

Could we inadvertently be creating confusion and angst amongst the healthcare community by spreading information via so many communication channels? I found myself confused by reading and trying to interpret all of the information that is flooding the internet regarding Meaningful Use. My hope is that social networks don’t decelerate the process toward achieving Meaningful Use by creating too much confusion, but instead serve as an efficient and cost-effective method of disseminating information, advice, etc.

Tom Callahan
Product Manager, Health Solutions