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NIST tackles EHR usability standards

GAITHERSBURG, MD. — Tuesday was a crazy day for U.S. health IT. First, the long-awaited meaningful use rules dropped. Those were “relaxed” from previous drafts, as one policy leader put it while speaking informally here at a National Institute of Standards and Technology (NIST) conference focused on electronic health record (EHR) usability.

That was just about all that was said about meaningful use, because no speaker or attendee had had a chance to review the final rule — except of course, for representatives of the Office of the National Coordinator (ONC) of Health IT in attendance. And they weren’t talking, so as not to upstage the festivities down in D.C., where agency top brass were formally unveiling the rule.

NIST has an interesting role in keeping the U.S. economy churning by developing measurement standards. The agency mandates standards for everyday things we take for granted, such as accurate, honest gas pumps and — we were constantly reminded, with the giant digital clocks ticking away above the conference stage — figuring out what time it is, officially.

It was refreshing, actually, to attend a NIST conference. The conference organizers were quite polite about it, but they quickly alerted speakers who ran over their allotted time, and the speakers quickly wrapped up whatever it was they were saying. That’s in stark contrast to other health IT conferences, where vendors sometimes take over the stage and take their time (and ours, too).

In the health IT space, NIST is seeking contractors to help determine how it will measure EHR usability and insert itself into the meaningful use debate. The agency spent all day Tuesday listening to stakeholders in the industry — vendors, researchers; thought leaders from HIMSS, ONC and the FDA; and EHR users, too — to understand how to best proceed in its work, which amounts to creating a reproducible set of rules for measuring how usable an EHR system is.

It could be that NIST ends up making voluntary recommendations for EHR usability, in tandem with the Agency for Healthcare Research and Quality, which helped organize the conference. It could be that the standards become regulatory law, part and parcel of NIST’s job managing EHR certification. Either way, both vendors and health care providers can register their suggestions with NIST right now and insert their own perspectives about what makes an EHR usable. Might as well, right? The decisions NIST is making right now could shape how EHR systems look — and work — for the next few decades.

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