Tuesday, February 18, 2014

The February HIT Standards Committee

The February HIT Standards Committee focused on development of the 2014 standards workplan, refinements to meaningful use stage 3 attestation/certification processes, and recommendations for standards to capture patient generated healthcare data.

Jon Perlin led the workplan discussion. Over the next 30-60 days, ONC will reflect on short term and long term policy goals, which will guide Federal Advisory Committee plan development.  We'll use the new strategic guidance to revise the structure of our workgroups/task forces/power teams with a special emphasis on the need for the Policy and Standards Committees to coordinate their work.   Standards Committee members discussed the need to address short term standards gaps while also thinking about medium term strategies (FHIR/REST) and long term aspirational goals (APIs, detailed clinical models).    All also agreed that now is the perfect time to pause and reflect on our progress to date, adjusting our trajectory if necessary.   We look forward to ONC guidance at our March/April meetings.

Next, we heard from Jodi Daniel and Doug Fridsma with an ONC update that covered 4 topics - a framework for thinking about a Learning healthcare system, HITPC letters of transmittal for feedback on specific standards, a Meaningful Use stage 3 review process, and the ONC 2015 Edition Certification NPRM.   A task force will be created to review the Meaningful Use Workgroup recommendations adding standards and implementation feedback such as maturity/applicability of standards and implementation difficulty.    The 2015 Edition of Certification will be voluntary and provides ONC a regulatory mechanism to polish the 2014 Edition based on industry feedback.   We're all optimistic that the 2015 Edition will reduce burden on all stakeholders.

Finally, we reviewed the recommendations for patient generated data and device data transmission to EHRs.   Commenters expressed concern about the balance between innovation at a time when the industry is evolving rapidly and providing highly constrained standards guidance to enhance interoperability.   We agreed that fully integrated shared patient/provider record systems do not need standards as they share a common database.    The Implementation Workgroup will survey the market to identify those classes of applications that would benefit from standards to enhance patient/provider communications across heterogeneous platforms.    We also agreed that devices are evolving rapidly and we should focus on the EHR's capability to receive data from devices/middleware using existing standards such as Direct and CCDA which are already part of Meaningful Use Stage 2

All agreed that the arrival of a new national coordinator brings positive change, new momentum, and a sense of optimism.

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