In health IT standards, how will providers be required to manage intellectual property considerations? Through the latest idea under deliberation by policymakers, not at all.
The vocabulary task force of the Health IT Standards Committee (HITSC) is exploring the possibility of national licenses for the intellectual property found within technology standards. That way, when providers implement vendor electronic health records (EHRs) that embed those standards, they will not also have to pay separate fees to standards developers for the work that went into creating them. Instead, the central authority would manage the fees. All of this relates to meaningful use, which requires doctors to adopt health IT to become eligible for incentive payments. That technology must follow certain standards.
Doctors, hospitals, vendors and standards development organizations all had their own thoughts about intellectual property and standards development to share during a day of testimony to the vocabulary task force in early September, at which policymakers sought feedback on the idea of a central standards repository. The task force distilled that testimony into a report for the full HITSC, which then directed the vocabulary team to consider methods that mitigate intellectual property obstacles.
That’s easier said than done. On top of the broad number of value sets that must be used in meeting meaningful use criteria, there are legal issues regarding what the government is authorized to license, according to Betsy Humphreys, deputy director of the National Library of Medicine and co-chair of the vocabulary task force. “The notion of the federal government negotiating with one private party for fees that are applied to other private parties across the state . . . this is extremely complex,” she told other group members during a recent meeting.
There is a precedent for the NLM doing just that, however: Its licensing of SNOMED-CT (Systematized Nomenclature of Medicine — Clinical Terms), allowed vendors and providers in the U.S. to incorporate those international standards into their EHRs, and avoid individual use agreements.
Standards developers also structure their licensing agreements in various ways, and some don’t charge user fees to begin with. That further complicates the development of one, across-the-board national policy, said Wes Rishel, vice president and analyst in Gartner’s health care provider research practice, who sits on the HITSC and helped found the Health Level Seven, or HL7, standards development organization. He said he sees an attempt to create a national license as an objective or direction, versus a hard and fast policy.
“The real issue we have,” Rishel said, “is a pragmatic one”: determining ways to mitigate the cost impact on providers as they implement health IT.