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HIT Policy Committee proposes new electronic health record standards

The Health IT Policy Committee has recommended new standards for sharing lab data through electronic health records, including vocabulary, messaging and transaction.

As the federal government prepares to roll out rules around meaningful use criteria this month, the national Health IT Policy Committee has included new standards recommendations for incorporating laboratory results in electronic health records (EHRs).

The committee suggests hospitals and providers follow specific messaging and lab protocols when ordering and delivering results. The recommendation comes from the research conducted by the committee’s workgroup on health information exchange.

Under the American Recovery and Reinvestment Act of 2009, the Centers for Medicare & Medicaid Services will offer financial incentives to providers that have implemented health IT and are using it in a meaningful way. The policy committee was established to help define the term meaningful use.

As part of the requirements to qualify for financial incentives, providers will have to incorporate lab data into their EHRs and information systems by 2011. While that requirement is in place, there is currently no set of standards for vocabulary, messaging and transaction that everyone will have to follow to ensure lab information is shared in a common form across different systems, according to Micky Tripathi, president and CEO for the Massachusetts eHealth Collaborative, who serves as co-chairman of the information exchange workgroup. Tripathi spoke during the committee meeting.

Current formats include “allowable alternatives” such as Health Level 7 (HL7) interfaces and local codes, Tripathi told the policy committee. But providers should be required to adopt standards that focus on the most frequently ordered lab tests for 2011, he said. The requirement includes a phase-in period for hospitals not currently using the right standards.

The recommendations include HL7 messaging standards and vocabulary standards by the Logical Observation Identifiers Names and Codes (LOINC) laboratory data set as well as the Systematized Nomenclature of Medicine (SNOMED) database of medical terminology.

While many labs use the HL7 interfaces now to send information to hospitals, changing to standardized delivery procedures will help, according to Charles Bartels, senior laboratory director at Truman Medical Centers Inc. in Kansas City, Mo.

As a person who’s going to be spending some money in this area over the next few years, I would prefer to have a named standard to target.

Roger Baker, CIO, Department of Veterans Affairs

Hospitals will be required to make investments to incorporate the recommended LOINC and SNOMED standards. But “I know I’ll be investing in the same processes,” and “whatever we do, we know it’s going to work the same for everybody,” said Bartels, who sits on the national lab council of Novation, an organization that provides hospitals with feedback on medical and lab supply purchasing decisions.

Truman, which plans to seek federal grant money to incorporate laboratory data into its electronic records system, currently has two direct electronic interfaces with the labs that conduct most of the testing for the hospital. When it sends patients’ tests to labs outside those interfaces, the results come back in a paper form and must be added manually to paper and electronic records, Bartels said. That labor-intensive project is a “huge expense” for the hospital, he added.

By including a standards requirement, providers looking to implement EHRs will have stronger guidance for choosing the right technology, said Roger Baker, CIO for the Department of Veterans Affairs, who sits on the policy committee. “As a person who’s going to be spending some money in this area over the next few years, I would prefer to have a named standard to target,” he said during the meeting.

The federal government is expected to issue a notice of proposed rulemaking for meaningful use criteria this month. Stakeholders will have a 60-day comment period after the rule is issued to provide feedback.

Let us know what you think about the story; email Jean DerGurahian, News Writer.

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