Thursday, October 06, 2011

It Seems There Might Just Be Another Way To Move Forward With E-Health. KISS!

Now here is an idea that will send shivers down the spine of those obsessed with unimplemented technical perfection within NEHTA.

ONC's Mostashari: 'We can't afford to wait another 5 years before we have exchange'

September 28, 2011 | Mary Mosquera
Dr. Farzad Mostashari, the national health IT coordinator, urged the Health IT Standards Committee to lean forward with standards that are “good enough” to get started on robust health information exchange instead of waiting until they gain maturity and wide adoption.
The lack of transport standards is one of the biggest barriers to providers’ sharing information on a national scale, he said. And it is holding back recognition of the progress made in stage 1 of meaningful use. Currently, exchange occurs mainly through proprietary exchange technology formats and Health Level 7 standards. 
Yet stage 2 meaningful use requirements will call for more complex health information exchange, he said at the Sept. 28 standards committee meeting, which advises the Office of the National Coordinator for Health IT (ONC). Providers need a portfolio of standards, tools and services to meet exchange goals.
“My request to you is to push. There is a sense in which not moving on anything is a greater risk than moving forward on something that may be imperfect,” Mostashari said. “We can’t afford to wait another five years before we have exchange in this country.” 
The committee wrestled with how to scale nationally the specifications for the nationwide health information network (NwHIN Exchange) and aspects of how data moves. NwHIN is the set of standards and services that enable typically large organizations and federal agencies to share information securely through the Internet. ONC wants to expand NwHIN Exchange participation.
The NwHIN team explored “if we were to adopt today standards for nationwide use, what seems directionally good enough for that particular purpose and what needs more work,” said Dr. John Halamka, committee co-chair and CIO of Beth Israel Deaconess Medical Center. The group provided its best observations and evaluation of what is available.
Standards, services and policies for NwHIN Exchange must be deployable within an architectural framework capable enough to support secure information exchange at a national scale. “The building blocks have to fit and operate within an architectural framework,” said Dixie Baker, NwHIN team lead and SAIC senior vice president and chief technology officer for health solutions.
More details are here:
When you have the US National Co-ordinator for Health IT saying we need to actually just get moving rather than obsessing with technical perfection all I can say is Yeah!
We have watched NEHTA now for over 5 years produce more documents than you could climb over - and where is all this work and cost actually making a difference? I am sure those who consult to or a paid by NEHTA are thrilled -but the clinicians and patients who they are meant to be serving - what have they had or really seen as yet.
There really is a crying need for a profound strategic review that focusses on working out just what can be moved into real implementation and have a real impact and how can this actually be achieved.
As they have recognised in the US, enough is enough! Let’s actually get going with practical and useful. And while we are doing that lets re-think the PCEHR and how it will work and be used to make it practical and useful!

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