The April HIT Standards Committee Meeting

john halamkaChair Perlin Steps Down Reorg is on the Agenda

By John Halamka, MD

The April Standards Committee began with a tribute to Jon Perlin, who is leaving his chair role of the HIT Standards Committee so that he can focus on his chair role at the American Hospital Association. Jacob Reider, Deputy National Coordinator will serve as the Standards committee chair. I will continue as vice-chair. Jon Perlin has done remarkable work as chair and I look forward to his continued service as a committee member.

Doug Fridsma presented a straw man for the evolution of the HIT Standards Committee Workgroups to better align with our domain expertise, especially as term limits require the rotation of members. The committee agreed that it made great sense to organize ourselves into content, vocabulary, transport/security, architecture/api/services, implementation/certification/testing groups. An overall steering committee will triage questions to the right groups and collate the responses from groups.

We then began a day long look at the 2015 Notice of Proposed Rulemaking.

  • Liz Johnson and Cris Ross presented comments from the Implementation Workgroup. Their key summary is reconsider the cost/benefits of frequent rule changes because there is:
    • No guarantee that the items contained in 2015 Edition will be part of 2017 Edition/MU Stage 3
    • Unclear benefits to provider community related to implementing an incremental update while continuing to gather data for attestation period in any fiscal year on 2014 Edition
    • Preference for vendors to focus on optimizing current code releases and begin preparation for MU Stage 3
    • Cost burden to both vendors and providers
  • Next, – Majorie Rallins and Danny Rosenthal presented the Clinical Quality Workgroup NPRM evaluation. Their key takeaways are that many of the quality standards required for the 2015 NPRM are not mature/fit for purpose and that energy should be spent improving QRDA 1 (patient level), not QRDA 2 (summary), or QRDA 3 (numerator/denominator calculations)
  • Next, Dixie Baker and Lisa Gallagher presented the Privacy and Security Workgroup Comments.
    Their key point was the need to to ensure there is some kind of non-prescriptive functional demonstration of modular EHR components working together to ensure data integrity and privacy.
  • Finally Dixie Baker and Walter Suarez presented the NSTIC Hearing Update. Their key takeaway is that NSTIC is not making standards, it is suggesting frameworks for use of existing standards. In particular OAuth and OpenID are likely to be increasingly important.

A great meeting. I am hopeful ONC will incorporate the balanced comments for the workgroups into their regulation writing.

John D. Halamka, MD, MS, is Chief Information Officer of Beth Israel Deaconess Medical Center, Chairman of the New England Healthcare Exchange Network (NEHEN), Co-Chair of the HIT Standards Committee, a full Professor at Harvard Medical School, and a practicing Emergency Physician. This article was originally published in his blog Life as a Healthcare CIO and is reprinted here with permission.