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Winds of change adjust health IT policy priority, focus

Information sharing initiatives such as NHIN Direct have shifted the focus of health IT policy. Federal committees and workgroups are redirecting their efforts accordingly.

More than a year into the making of health information technology policy, the officials steering the discussion have begun to see a realignment of priorities, issues and work, with additional emphasis being placed on sharing information among state and federal agencies and electronically enrolling the uninsured.

Members of the information exchange workgroup of the Health IT Policy Committee have presented an updated agenda of issues on which they expect to focus for the rest of the year. The policy committee held its regular monthly meeting May 19 and heard updates from several of its workgroups.

While its agenda is still being made final, the information exchange workgroup has concluded it needs to address policy issues in "breakthrough" areas within state health information exchanges, said Micky Tripathi, president and CEO of the Massachusetts eHealth Collaborative and the workgroup's co-chairman.

When the Health IT Policy Committee first established workgroups last year, the information exchange agenda was broader. Since then, the information exchange workgroup has split into workgroups that focus on the National Health Information Network (NHIN) and privacy and security.

With a narrower agenda, the information exchange workgroup will look for policy gaps and barriers to effective information sharing at the state level and how that is affected by national policy issues, Tripathi said during the meeting. "The last thing we want is to create redundancy."

In addition, the workgroup hopes to bring in new members that reflect its readjusted agenda while working with other workgroups and members of the Health IT Standards Committee, Tripathi said.

David Blumenthal, head of the Office of the National Coordinator for Health Information Technology (ONC) and chairman of the Health IT Policy Committee, applauded the information exchange workgroup's direction. He called it a "nice example" of a workgroup addressing changing policy needs.

Meanwhile, the efforts of that workgroup seem to have inspired some shifts among a few of the other workgroups. David Lansky, president and CEO of the Pacific Business Group on Health and chairman of the policy committee's NHIN workgroup, also saw the need to re-craft that workgroup's plans to provide guidance for stakeholders in the NHIN Direct project.

NHIN Direct is the first test case of the NHIN's trust framework, and there have been some questions and confusion arising from it, Lansky told the Health IT Policy Committee. The NHIN workgroup is trying to apply broad-level policy to developers in the field, and it's colliding with privacy and security issues and with technical requirements. Wes Rishel, another member of the policy committee, said in a separate interview that he expects the various organizations working with NHIN and NHIN Direct will reach consensus.

The last thing we want is to create redundancy.

Micky Tripathi, co-chairman, Health IT Policy Committee's information exchange workgroup

"Some of the questions we didn't know could be triggered by the [NHIN] Direct project were triggered," said Lansky, who added that the NHIN workgroup hopes to collaborate more with the privacy and security workgroup, as well as the realigned information exchange workgroup. "We've been taking a very deliberate approach, and now I think we have to move more expeditiously."

And as if attending to the evolving requirements for policy governing the federal health IT rollout was not enough work, the Health IT Policy Committee was given an update on yet another workgroup it will help form. Under the health reform law, the ONC has been tapped to create standards for enrolling uninsured people in state insurance programs electronically, the goal being to help people who contact other state and federal social services programs find their way to health insurance programs. While those programs do not go into effect until 2014, under the new law, the ONC is required to submit its recommendations for standards by September.

The new enrollment workgroup will consist of members of both the policy and standards committees, as well as experts in the field, according to Jodi Daniel, director of ONC's office of policy and research. ONC hopes to convene the group in June and begin biweekly meetings.

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

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