Just when stakeholders and policymakers thought they were busy enough developing health IT standards for meaningful use, more work is on the way.
Ruefully remarking that “no good deed goes unpunished,” David Blumenthal, the physician who heads the Office of the National Coordinator for Health IT (ONC), told the Health IT Standards Committee (HITSC) it soon will be working on standards around electronic insurance enrollment, as well.
The latest assignment stems from the health reform law. Under Sec. 1561 of Title I of the law, the HIT policy and standards committees must work with ONC on developing “interoperable and secure standards and protocols that facilitate enrollment of individuals in federal and state health and human services programs.”
There was a round of chuckles from committee members reacting to Blumenthal’s announcement, but little more on what’s coming was described during the April 28 meeting.
The majority of federal IT initiatives were spelled out in the HITECH Act of the stimulus law last year, and not in this year’s health reform bill. Both the policy and standards committees have been developing the rules for launching those initiatives over the last 12 months.
ONC told the committee it continues to analyze comments received on the standards interim final rule that accompanied the meaningful use proposed rule released by the Centers for Medicare & Medicaid Services. Both ONC and the CMS hope to have final rules released around the same time later in the spring.
The HITSC also heard updates from its workgroups, which have been focused on standards that will allow IT to meet meaningful use requirements. Patient engagement — a topic of interest for the policy committee lately, as well — was addressed by the privacy and security workgroup.
The committee should focus on standards for activities that bring doctors and physicians into closer electronic communication for stages 2 and 3, said HITSC member Dixie Baker, senior vice president of Science Applications International Corp. and chief technology officer of its health solutions business unit. While things like e-messaging, clinical summaries and delivering real-time information to personal health records are components of meaningful use, “it’s very, very clear” that there aren’t any standards in those areas yet, she said.
The committee needs to ask how developers can capture patient consents, privacy, define “real-time” data and consider how home devices and patient-generated data fit into electronic health records, Baker said.
But others believe the issue isn’t a lack of standards, say other committee members. Despite the absence of standardization, “we and other organizations in the country are doing practically all of these,” said James Walker, physician and chief health information officer for Geisinger Health System. He added the committee should start to think about which patient engagement standards are needed and how to incorporate them simply with other IT standards development.