A notice of proposed rulemaking to oversee Nationwide Health Information Network (NHIN) standards is on its way.
During the June 25 meeting of the Office of the National Coordinator for Health Information Technology’s Health IT Policy Committee, Mary Jo Deering from the ONC’s Office of Policy and Planning noted that the ONC has done some preliminary analysis of what NHIN standards and governance should look like but also intends, come September, to ask the committee for input in drafting the proposed rule.
The Health Information Technology for Economic and Clinical Health, or HITECH, Act set forth the rulemaking process as a means of “establish[ing] a governance mechanism” for the NHIN. The rule for the NHIN standards is meant to complement existing governance, including the Health Information Portability and Accountability Act and the ancillary HIPAA Security and HIPAA Privacy rules, Deering said.
Much remains to be done. The NHIN governance requirements must cover five of what Deering described as the “domains of [health information exchange] trust”: policy and legal requirements, transparency, enforcement and accountability, identity assurance, and technical requirements. Even the scope of governance needs to be determined: Shall participation and compliance with NHIN standards, for example, be optional, preferred or mandatory? Under what conditions should governance be applied? There’s also the question of whether the same standards will apply to NHIN Direct, a broader data exchange standard that targets solo or small-practice physicians.
Guidance on NHIN standards will go a long way toward showing health care organizations what it will take to tap into health information exchange, however. So, even though the ONC and its policy committee are plenty busy with electronic health record certification and meaningful use, one can only hope the work with NHIN governance does not wait too long.