HIT Standards Commitee Work Groups to Focus on Data Exchanges that Constitute Meaningful Use

Under the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act), the Office of National Coordinator for Health Information Technology (ONC) and the United States Department of Health and Human Services (HHS) are vested with authority to further define “meaningful use” as it relates to qualifying to receive stimulus funds for the adoption and implementation of electronic health records (EHRs). ONC’s Health Information Technology (HIT) Standards Committee is vested with authority under HITECH to propose a national HIT standard for EHRs that takes into consideration “meaningful use” and interoperability. In order to meet the HITECH Act’s December 31, 2009 deadline for coming up with this standard, however, the HIT Standards Committee must begin its work before “meaningful use” is further defined. Accordingly, during its first meeting on May 15, 2009, the HIT Standards Committee identified three primary data exchanges that would be integral to “meaningful use.” These data exchanges are: 1) Clinical Operations; 2) Quality; and 3) Security. The HIT Standards Committee formed a work group for each of these types of data exchanges.

Clinical operations HIT data exchanges would include e-prescribing and medication management, lab ordering and results, and a clinical summary exchange. The clinical summary exchange would be critical to enabling physicians and practitioners unfamiliar with a patient’s history to retrieve the most important facts quickly. For example, a clinical summary might include the patient’s problem list, medications, allergies, and text based reports such as operating notes, diagnostic testing reports, and discharge summaries.

Quality HIT data exchanges might include information about patient outcomes and treatment plans, patient health behaviors, and physician and practitioner medical decision making.

Secure HIT data exchanges would necessary require considerations of transport, messaging, authentication, authorization, and auditing.

The first meeting date for each work group is as follows: Clinical Operation — June 9, 2009, 10 am to 12 Noon EDT; Quality work group — June 10, 2009, 11 am to 1 pm EDT; Security work group — June 17, 2009, 11:15 am to 1:15 pm EDT.

John D. Halamka, M.D., Vice Chair of the HIT Standards Committee, provided a summary of the April 15, 2009 HIT Standards Committee meeting on his blog entry for May 15, 2009. Mr. Halamka also summarized the first meeting of the HIT Policy Committee on May 12, 2009, on his blog here.

Looking for proposals for the definition of “meaningful use”?

Providers who wish to receive incentive payments under the American Recovery and Reinvestment Act of 2009 (ARRA), and more specifically, the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act), for the adoption and implementation of an electronic health record (EHR) must meet specific requirements, one of which is to demonstrate that the provider is making a “meaningful use” of the EHR. The HITECH Act vests authority in the Secretary for the U.S. Department of Health & Human Services (HHS) to further define “meaningful use.” HHS does not intend to come up with this definition in a vacuum and has solicited input. Such input poured in on April 28 & 29, 2009, when the HHS National Commmitee on Vital and Health Statistics held public hearings to discuss “meaningful use.”

In a HealthLeaders Media article on May 5, 2009, the author, Carrie Vaughn, prepared a summary and provided links to the several associations and industry groups who weighed in on the definition of “meaningful use.” Among the organizations who submitted proposals were CHIME, AHIMA, AMIA, ANI, HIMSS, and The Markle Foundation. Vaughn observed that the proposals seemed to agree that “meaningful use” should focus on “desired outcome, which is improving quality of care, reducing costs, and making care delivery more efficient, not the technology itself.” Another common thread among the proposals was to implement the standards using an “incremental approach” that can become more stringent with time. To read the article, click here.