The May HIT Standards Committee focused on the ONC Governance RFI and how best to think about standards and policy for building trust among healthcare information exchange network participants
We also reviewed the Query Health project, Quality measurement project efforts, and the continuing work to create a national library of medicine curated vocabulary/code set repository in support for meaningful use.
The meeting began with a description by Farzad that our work on the Governance RFI should result in "interoperability that just works". Instead of plug and pray, it should be plug and play. No one should have to negotiate trading partner agreements one by one.
Jon Perlin outlined the work recently done by the National Cancer Institute to envision a learning healthcare system based on information exchange and decision support. It is no longer a dream, but is becoming a reality.
Steve Posnack from ONC presented the Governance RFI which is summarized on this blog post.
The discussion that followed was very robust with two major recommendations
a. Policy should be "modular" - the requirements to be a Network Validated Entity should vary based on the services offered. It's quite different to be a repository of deidentified data verses a full Nationwide Health Information Network participant supporting a "pull" model for records based on a master patient index/record locator service.
b. Policy should be separated from standards/certification, since policy may change at a slower rate than technology. The current Meaningful Use Program separates attestation and certification, and such an approach seems prudent.
Dixie Baker presented an analysis on the RFI from the NwHIN Power Team and the Privacy & Security Workgroup . Her comments provided many valuable refinements to the RFI and further bolster the case for separating policy and standards/certification details when defining criteria for trusted healthcare data exchange
Richard Elmore presented an overview of the Query Health program including current pilots and next steps. Massachusetts is proud to be a participant in this ground breaking effort to send questions to the data rather than data to a central repository.
Jim Walker presented the work of the Essential Components Tiger Team which included recommendations for federal action to make usable and useful value sets available for Meaningful Use Stage 2.
Betsy Humphreys presented an overview of the latest NLM work to provide curated code sets, vocabularies and cross-maps. She offered us optimistic comments that ONC and NLM are working hard to operationalize the HIT Standards Committee request for hosting these code sets in one central location for any stakeholder to access at no charge.
A very rich agenda that represents the maturity of the standards harmonization process. We're no longer debating basic vocabulary, content, and transport standards - we're thinking about advanced ways to enable an ecosystem of data exchange.