Thursday, December 19, 2013

The December HIT Standards Committee

The December HIT Standards Committee focused on patient generated data, image sharing, patient matching, and the 2014 work plan, ensuring we select the necessary standards to support Meaningful Use stage 3 policy goals.

We began the meeting with a discussion by Leslie Kelly-Hall of patient generated healthcare data - structured and unstructured questionnaires plus patient provided medical history such as medications, allergies, and problems.      The key discussion was an evaluation of the standards maturity and the level of adoption of the standards suggested for patient generated data exchange.  Recommendations included Direct for data transport, CCDA for content capture, LOINC/SNOMED for vocabulary capture, and Continua implementation guides for devices.   As a followup the Consumer Technology Workgroup will list examples of CCDA templates that can be used to support patient generated data use cases.   Continua will provide us a list of the named standards so that we can validate the maturity and adoption of Continua's implementation guides.  We will also ensure that the CCDA templates include the appropriate vocabularies that will  enable incorporation of patient generated data into EHRs.

Next, Jamie Ferguson presented an overview of the standards selected for radiology and non-radiology image exchange, including associated reports.  Our challenge was to provide a parsimonious collection of constrained standards for consumer and professional applications in tightly coupled (modality to PACS), and loosely coupled (web-based, cloud hosted image exchange) architectures.   We all agreed that we need to be very careful when writing certification criteria to avoid optionality such that vendors will be forced to implement many different standards (the "OR" of meaningful use becomes the "AND" of certification).

Next, Lee Stevens presented the work done to date on Patient Matching. We all look forward to ONC's final recommendations for optimizing data quality, selecting matching algorithms (deterministic or probabilistic), and choosing data elements that will provide reasonable sensitivity and specificity.

Finally Doug Fridsma a straw man plan for reorganizing the HITSC workgroups, spreading the work ahead across more people to enhance our agility and reduce volunteer burn out.   All thought  the reorganization and work plans were reasonable but suggested two additions.  First, we'll need another workgroup that focuses on research/creating a learning healthcare system.   Second, we need to ensure that each workgroup reserves time for future planning and does not limit its scope to selection of incremental standards to solve today's urgent needs.  We'll implement future planning by adding it to each workgroup's agenda and implementing a matrixed management approach for communication and coordination of future planning among the workgroups.

The FY14 work ahead looks well prioritized and categorized.   Our next meeting will be in February when we'll be joined by the new National Coordinator for Healthcare IT, Karen DeSalvo 


Rob McLellan said...

Interesting to read the presentation on Patient Matching. National Statistical Organizations have invested in algorithmic approaches to record linkage with high probability to deal with analysis across disparate collected/ administrative data sets to arrive at high quality analysis results. There may be software or algorithmic ideas that are relevant here, for sharing, etc. Just a thought...

Unknown said...

The next steps in the Meaningful Use Stage III Work Group's Draft Recommendations states (on slide 74) "MU WG will incorporate HITPC feedback into revised recommendations to be presented for HITPC approval September 4"

Do you have any information about the HITPC feedback? Was unable to locate anything online.

Tom Doerr