The high-profile commission formed by the federal government to advance healthcare information technology (HIT) has made its first 28 recommendations, setting goals to take several actions very quickly.
At a meeting earlier this year, the American Health Information Community (AHIC) recommended:
that the federal HIT effort work with stakeholders to develop a plan for laboratory information flow by March 31, 2007, including endorsement of vocabulary, messaging and implementation standards for the most common test results by this September;
that public and private payers move quickly, probably this year, on pilot projects to evaluate secure messaging, such as e-mail, between physicians and patients. The evaluation will include assessment of reimbursement for physicians doing messaging, integration of the messaging into physician workflow and its impact on patients' involvement in their care;
that there be standards developed and pilot programs run this year for electronic personal health records, to be controlled by patients and to include at least the patient's registration information and medication history;
that the Department of Health and Human Services (HHS) accept the certification criteria for ambulatory electronic medical records that was recently finalized by the Certification Commission for Healthcare Information Technology (CCHIT).
The 17-member AHIC includes a range of top public and private leaders, such as Scott Serota, president and CEO, Blue Cross and Blue Shield Association (Chicago); Mark McClellan, M.D., Ph.D., head of the Centers for Medicare and Medicaid Services; and William Winkenwerder, Jr., M.D., assistant secretary of defense for health affairs.
The AHIC recommendations come with the assumption the department will move on them, since HHS Secretary Michael Leavitt chaired the meeting himself, with out-going national HIT coordinator David Brailer, M.D., Ph.D. at his side. Leavitt opened the meeting by saying he had 980 days remaining to be department head, that HIT is at the heart of all the HHS priorities he has set, and he feels constant urgency to make breakthroughs in the area.
Leavitt labeled as an important moment for HHS, in particular, the endorsement of the criteria for the certification of ambulatory records. He reminded AHIC that the department is proposing a regulation change to allow hospitals and health plans to donate computer hardware, software, and expertise to physicians and others. And that new rule will require any donated software meet these new criteria.
The certification criteria require the records to have certain capabilities in functionality, interoperability and security. For example, certified systems must be able to capture external clinical documents, generate and record patient-specific instructions, and enable orders for medications and diagnostic tests. They also must be able to manage results, as in routing and presenting current and historical test results for professionals to review, filter and compare.
The first certification process was launched in May with more than two dozen applications from system vendors. Mark Leavitt, M.D., Ph.D., who is CCHIT chair, says this first certification round has attracted many of the larger vendors in the field, as well as some smaller ones. The process is to be repeatedly quarterly.
The criteria's 18-month development included participation by hundreds of providers, vendors, and payers including representatives from both the public and private sectors, according to the CCHIT chair, and the commission received over 2,000 public comments. Six vendors did a pilot test of the criteria prior to this first certification round, he said.
CCHIT plans to begin developing certification criteria for inpatient records this year. It will also be updating the ambulatory record criteria. The organization expects to begin work on criteria for networks later this year, with the goal of beginning that certification in May 2008.
Kathryn Foxhall is a freelance writer based in Hyattsville, Md.
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